The combination of Perjeta and Herceptin, which initially exudes an indisputable advance in the metastatic stage, was subsequently approved for its use in precocious disease (both in the neoadyuvial entourage as adjuvant), although there are more +2 results.
In breast cancer precociously consider factors such as tumor size, degree of malignancy, expression of hormonal receptors and metastasis in the ganglia. Patients with cancer precocious to HER2 + who have high risk of recovery at the time of diagnosis suelen receive neoadyuvial treatment with antiHER2 + therapy and chemotherapy. Tal y como recoge la Sociedad Española de Oncología Médica (SEOM)1, the neoadyuvial treatment of this type of cancer presents important winds for the patients. In addition to allowing the reduction of the tumor to facilitate the surgical resection and increasing the maturation tasks of the mother, the prognosis of the nurse increases and allows a temperament evaluation of the treatment to be performed in the preterm infant.
The indication of Perjeta in combination with trastuzumab in neoadyuvancia is approved thanks to the benefit demonstrated in the Neosphere studies2 y Tryphaena3. The results of these studies were established at Perjeta Junto with Herceptin and chemotherapy as the new non-adjuvant treatment of reference in the cancer of the mother precocious HER2 +.
In real clinical practice, tal and as observed in the Neopersur studios4 and Neopetra5, the results of pCR alcanzados tras the treatment neoadyuvante with Perjeta its comparable including superior to the obtenidos in the clinical trials2,3,6
Joan Albanell, Jefe de Oncología del Hospital del Mar de Barcelona, commented on the importance of neoadyuvial treatment in breast cancer precocious HER2 +.
Is there any way to prevent breast cancer?
The most important factor of risk is the age, as this can be done. On the other hand, there is a series of factors related to the style of living that help reduce the risk of breast cancer and increase overall health. The most restricted are a healthy diet rich in fruits, vegetables and carotenoids, and regular physical activity, but also avoid overeating in postmenopausal women, and alcohol consumption. There are many other factors, but more difficult modulation, and others in the studio. In addition, there are between 5 and 10% of hereditary cancers, and there are various means to reduce the risk of breast cancer in women who carry hereditary hereditary mutations.
What patients with cancer precociously HER2 + their candidates to receive a neoadyuvence and what is the best way to take this decision?
In breast cancer precoc HER2 +, we apply neoadjuvant therapy in patients with tumors larger than 2 cm or with positive regional ganglia. In more tumors and with negative ganglia, surgery is the initial therapy of choice, following adjuvant treatment, with excellent results. In addition, the population in which we apply neoadjuvant therapy is the mayor’s risk, and the applications because it supports various winds in terms of chiropractic strategy and adjuvant therapy. The best way to handle this decision is through multidisciplinary tumor committees. Although these committees are extensively developed in our country, we have patients who are not valued in committees and are candidates for neoadjuvant therapy, not the recipient. It is important to correct these situations because as he says, neoadjuvant therapy is the best option.
What are the benefits of neoadyuvial treatment?
As he pointed out, the treatment of neoadyuvante offers important sales. In the first place, reduce the size of the tumor, appearing in many cases. This reduction in tumor volume allows less aggressive surgeries to be performed, reducing the number of mastectomies and enabling conserving surgeries with better results. The second major event is that we are allowed to analyze the pathological response. In addition to having a complete pathological response to it, in cambio, having residual enema in the surgical area, we can plant as a type of adjuvant treatment we will agree. This ability to individualize treatment is based on a clinical trial7 in which patients with residual infertility are randomized to receive trastuzumab or T-DM1 adjuvant. The group of patients receiving T-DM1 presented an invasive risk-taking ratio of deaths 50% lower than those receiving the traditional treatment, trastuzumab. These results are subject to T-DM1 approval by regulatory agencies.
What is the neoadyuvial treatment with Perjeta and Herceptin for patients with cancer precocious HER2 +? And what are you doing as an oncologist?
The combination of anti-HER2 + anti-cancer and anti-inflammatory drugs combined with chemotherapy is the neoadyuvial therapy option offered by the mayor’s case of clinical and pathological complete responses. This is practiced at a practical level in both cases. First, a mayor’s number of patients is subject to less aggressive surgeries. Second, by reducing the likelihood of residual infertility, the mayor avoids risk to the patient, as well as reducing costs for the associated sanitary system and additional emergency care needs. When we introduce a complete pathological response we have a great satisfaction because we know the probability that the patient is brave is the mayor that there is residual illness. It is obvious to the mayor that the patient and the satisfaction of all professionals. Welcome to the multidisciplinary committees, when we present a patient who has raised this issue, we have many more content.