Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach

Ida Micaily; Lakshmi Kolandra; Shahrzad Abdollahi; Anthony Scarpaci

doi:doi:10.11648/j.ijcocr.20180303.11

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Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach

Ida Micaily, Lakshmi Kolandra, Shahrzad Abdollahi, Anthony Scarpaci

Published in International Journal of Clinical Oncology and Cancer Research (Volume 3, Issue 3)

Received: 7 June 2018 Accepted: 26 June 2018 Published: 24 July 2018

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Abstract

Metastatic hormone-receptor and HER-2 positive (triple-positive) breast cancer provides a treatment dilemma for oncologic clinicians. The current National Comprehensive Cancer Network (NCCN) Guidelines offer a variety of options in the first and second line for metastatic breast cancer. However, a more tailored treatment approach may be needed for the triple-positive metastatic breast cancer population. The aim of this study is to trend the therapeutic treatment selections for patients with metastatic, triple-positive breast cancer at a single, academic-affiliated community practice in the United States. The patient population included individuals with triple-positive, metastatic breast cancer who were treated over the span of six years at this institution. Ultimately, this patient population demonstrated variability across the various treating oncologists choice of therapy in the first, second and fourth line of treatment. The majority of patients (twelve out of fifteen) received combination therapy with trastuzumab in the first line of therapy. In the second line, seven out of eight patients received trastuzumab as part of their treatment regimen. In the third line, all three patients received trastuzumab emtansine as part of their therapy regimen. For patients who were able to survive until the fourth line and beyond, several other treatment options were utilized. Therefore, although metastatic, triple-positive breast cancer represents a subset of patients with vast treatment variability throughout the various lines of therapy, and there is a general lack of consensus on how to best treat this patient population. This study provides an opportunity for more expansive research in the field in order to help elucidate a treatment algorithm for all oncologic practitioners for patients with triple positive, metastatic breast cancer.

Published in	International Journal of Clinical Oncology and Cancer Research (Volume 3, Issue 3)
DOI	10.11648/j.ijcocr.20180303.11
Page(s)	20-24
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Breast, Metastatic, Triple-Positive

References

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[11]	Verma S: Clinical algorithm for HER2-positive metastatic breast cancer. 2018 Miami Breast Cancer Conference. Invited Lecture. Presented March 9, 2018.
[12]	Gelmon KA, Boyle FM, Kaufman B, et al: Lapatinib or trastuzumab plus taxane therapy for human epidermal growth factor receptor 2-positive advanced breast cancer: Final results of NCIC CTG MA. 31. J Clin Oncol 33:1574-1583, 2015.
[13]	Awada A, Colomer R, Inoue K, et al: Neratinib plus paclitaxel vs trastuzumab plus paclitaxel in previously untreated metastatic ERBB2-positive breast cancer: The NEfERT-T randomized clinical trial. JAMA Oncol 2:1557-1564, 2016.
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[18]	Andre, F, O’Regan R, Ozguroglu M, et al: Everolimus for women with trastuzumab-resistant, HER2-positive, advanced breast cancer (BOLERO-3): A randomised, double-blind, placebo-controlled phase 3 trial. Lancet Oncol 15:580-591, 2014.
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[21]	Blackwell KL, Burstein HJ, Storniolo AM, et al: Randomized study of lapatinib alone or in combination with trastuzumab in women with ErbB2-positive, trastuzumab-refractory metastatic breast cancer. J Clin Oncol 28:1124-1130, 2010.
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[23]	Gradishar WJ, Hegg R, Im SA, et al: Phase III study of lapatinib (L) plus trastuzumab (T) and aromatase inhibitor (AI) vs T+AI vs L+AI in postmenopausal women with HER2+, HR+ metastatic breast cancer: ALTERNATIVE. 2017 ASCO Annual Meeting. Abstract 1004. Presented June 3, 2017.
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APA Style

Ida Micaily, Lakshmi Kolandra, Shahrzad Abdollahi, Anthony Scarpaci. (2018). Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach. International Journal of Clinical Oncology and Cancer Research, 3(3), 20-24. https://doi.org/10.11648/j.ijcocr.20180303.11

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ACS Style

Ida Micaily; Lakshmi Kolandra; Shahrzad Abdollahi; Anthony Scarpaci. Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach. Int. J. Clin. Oncol. Cancer Res. 2018, 3(3), 20-24. doi: 10.11648/j.ijcocr.20180303.11

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AMA Style

Ida Micaily, Lakshmi Kolandra, Shahrzad Abdollahi, Anthony Scarpaci. Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach. Int J Clin Oncol Cancer Res. 2018;3(3):20-24. doi: 10.11648/j.ijcocr.20180303.11

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@article{10.11648/j.ijcocr.20180303.11,
  author = {Ida Micaily and Lakshmi Kolandra and Shahrzad Abdollahi and Anthony Scarpaci},
  title = {Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {3},
  number = {3},
  pages = {20-24},
  doi = {10.11648/j.ijcocr.20180303.11},
  url = {https://doi.org/10.11648/j.ijcocr.20180303.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20180303.11},
  abstract = {Metastatic hormone-receptor and HER-2 positive (triple-positive) breast cancer provides a treatment dilemma for oncologic clinicians. The current National Comprehensive Cancer Network (NCCN) Guidelines offer a variety of options in the first and second line for metastatic breast cancer. However, a more tailored treatment approach may be needed for the triple-positive metastatic breast cancer population. The aim of this study is to trend the therapeutic treatment selections for patients with metastatic, triple-positive breast cancer at a single, academic-affiliated community practice in the United States. The patient population included individuals with triple-positive, metastatic breast cancer who were treated over the span of six years at this institution. Ultimately, this patient population demonstrated variability across the various treating oncologists choice of therapy in the first, second and fourth line of treatment. The majority of patients (twelve out of fifteen) received combination therapy with trastuzumab in the first line of therapy. In the second line, seven out of eight patients received trastuzumab as part of their treatment regimen. In the third line, all three patients received trastuzumab emtansine as part of their therapy regimen. For patients who were able to survive until the fourth line and beyond, several other treatment options were utilized. Therefore, although metastatic, triple-positive breast cancer represents a subset of patients with vast treatment variability throughout the various lines of therapy, and there is a general lack of consensus on how to best treat this patient population. This study provides an opportunity for more expansive research in the field in order to help elucidate a treatment algorithm for all oncologic practitioners for patients with triple positive, metastatic breast cancer.},
 year = {2018}
}

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TY  - JOUR
T1  - Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach
AU  - Ida Micaily
AU  - Lakshmi Kolandra
AU  - Shahrzad Abdollahi
AU  - Anthony Scarpaci
Y1  - 2018/07/24
PY  - 2018
N1  - https://doi.org/10.11648/j.ijcocr.20180303.11
DO  - 10.11648/j.ijcocr.20180303.11
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 20
EP  - 24
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20180303.11
AB  - Metastatic hormone-receptor and HER-2 positive (triple-positive) breast cancer provides a treatment dilemma for oncologic clinicians. The current National Comprehensive Cancer Network (NCCN) Guidelines offer a variety of options in the first and second line for metastatic breast cancer. However, a more tailored treatment approach may be needed for the triple-positive metastatic breast cancer population. The aim of this study is to trend the therapeutic treatment selections for patients with metastatic, triple-positive breast cancer at a single, academic-affiliated community practice in the United States. The patient population included individuals with triple-positive, metastatic breast cancer who were treated over the span of six years at this institution. Ultimately, this patient population demonstrated variability across the various treating oncologists choice of therapy in the first, second and fourth line of treatment. The majority of patients (twelve out of fifteen) received combination therapy with trastuzumab in the first line of therapy. In the second line, seven out of eight patients received trastuzumab as part of their treatment regimen. In the third line, all three patients received trastuzumab emtansine as part of their therapy regimen. For patients who were able to survive until the fourth line and beyond, several other treatment options were utilized. Therefore, although metastatic, triple-positive breast cancer represents a subset of patients with vast treatment variability throughout the various lines of therapy, and there is a general lack of consensus on how to best treat this patient population. This study provides an opportunity for more expansive research in the field in order to help elucidate a treatment algorithm for all oncologic practitioners for patients with triple positive, metastatic breast cancer.
VL  - 3
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Author Information

Ida Micaily

Department of Internal Medicine, Abington Hospital Jefferson Health, Abington, Pennsylvania, USA
Lakshmi Kolandra

Department of Internal Medicine, Abington Hospital Jefferson Health, Abington, Pennsylvania, USA
Shahrzad Abdollahi

Department of Internal Medicine, Abington Hospital Jefferson Health, Abington, Pennsylvania, USA
Anthony Scarpaci

Department of Medical Oncology, Abington Hospital Jefferson Health, Abington Pennsylvania, USA

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APA Style

Ida Micaily, Lakshmi Kolandra, Shahrzad Abdollahi, Anthony Scarpaci. (2018). Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach. International Journal of Clinical Oncology and Cancer Research, 3(3), 20-24. https://doi.org/10.11648/j.ijcocr.20180303.11

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ACS Style

Ida Micaily; Lakshmi Kolandra; Shahrzad Abdollahi; Anthony Scarpaci. Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach. Int. J. Clin. Oncol. Cancer Res. 2018, 3(3), 20-24. doi: 10.11648/j.ijcocr.20180303.11

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AMA Style

Ida Micaily, Lakshmi Kolandra, Shahrzad Abdollahi, Anthony Scarpaci. Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach. Int J Clin Oncol Cancer Res. 2018;3(3):20-24. doi: 10.11648/j.ijcocr.20180303.11

Copy | Download

@article{10.11648/j.ijcocr.20180303.11,
  author = {Ida Micaily and Lakshmi Kolandra and Shahrzad Abdollahi and Anthony Scarpaci},
  title = {Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {3},
  number = {3},
  pages = {20-24},
  doi = {10.11648/j.ijcocr.20180303.11},
  url = {https://doi.org/10.11648/j.ijcocr.20180303.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20180303.11},
  abstract = {Metastatic hormone-receptor and HER-2 positive (triple-positive) breast cancer provides a treatment dilemma for oncologic clinicians. The current National Comprehensive Cancer Network (NCCN) Guidelines offer a variety of options in the first and second line for metastatic breast cancer. However, a more tailored treatment approach may be needed for the triple-positive metastatic breast cancer population. The aim of this study is to trend the therapeutic treatment selections for patients with metastatic, triple-positive breast cancer at a single, academic-affiliated community practice in the United States. The patient population included individuals with triple-positive, metastatic breast cancer who were treated over the span of six years at this institution. Ultimately, this patient population demonstrated variability across the various treating oncologists choice of therapy in the first, second and fourth line of treatment. The majority of patients (twelve out of fifteen) received combination therapy with trastuzumab in the first line of therapy. In the second line, seven out of eight patients received trastuzumab as part of their treatment regimen. In the third line, all three patients received trastuzumab emtansine as part of their therapy regimen. For patients who were able to survive until the fourth line and beyond, several other treatment options were utilized. Therefore, although metastatic, triple-positive breast cancer represents a subset of patients with vast treatment variability throughout the various lines of therapy, and there is a general lack of consensus on how to best treat this patient population. This study provides an opportunity for more expansive research in the field in order to help elucidate a treatment algorithm for all oncologic practitioners for patients with triple positive, metastatic breast cancer.},
 year = {2018}
}

Copy | Download

TY  - JOUR
T1  - Metastatic Hormone and Her-2 Positive Breast Cancer: A Community Approach
AU  - Ida Micaily
AU  - Lakshmi Kolandra
AU  - Shahrzad Abdollahi
AU  - Anthony Scarpaci
Y1  - 2018/07/24
PY  - 2018
N1  - https://doi.org/10.11648/j.ijcocr.20180303.11
DO  - 10.11648/j.ijcocr.20180303.11
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 20
EP  - 24
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20180303.11
AB  - Metastatic hormone-receptor and HER-2 positive (triple-positive) breast cancer provides a treatment dilemma for oncologic clinicians. The current National Comprehensive Cancer Network (NCCN) Guidelines offer a variety of options in the first and second line for metastatic breast cancer. However, a more tailored treatment approach may be needed for the triple-positive metastatic breast cancer population. The aim of this study is to trend the therapeutic treatment selections for patients with metastatic, triple-positive breast cancer at a single, academic-affiliated community practice in the United States. The patient population included individuals with triple-positive, metastatic breast cancer who were treated over the span of six years at this institution. Ultimately, this patient population demonstrated variability across the various treating oncologists choice of therapy in the first, second and fourth line of treatment. The majority of patients (twelve out of fifteen) received combination therapy with trastuzumab in the first line of therapy. In the second line, seven out of eight patients received trastuzumab as part of their treatment regimen. In the third line, all three patients received trastuzumab emtansine as part of their therapy regimen. For patients who were able to survive until the fourth line and beyond, several other treatment options were utilized. Therefore, although metastatic, triple-positive breast cancer represents a subset of patients with vast treatment variability throughout the various lines of therapy, and there is a general lack of consensus on how to best treat this patient population. This study provides an opportunity for more expansive research in the field in order to help elucidate a treatment algorithm for all oncologic practitioners for patients with triple positive, metastatic breast cancer.
VL  - 3
IS  - 3
ER  -

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