Neratinib is now approved for use in HER2 positive patients who completed their Trastuzumab-based therapy. This came following the publication of a phase 3 trial with the result indicating the benefit of Neratinib as compared to placebo. In the following blog post I will discuss the result of the ExteNET trial.
Background: Sentinel lymph node biopsy (SLNB) is now the standard of care used in the staging of the regional lymph nodes in breast cancer. As result of the wide adoption of SLNB attention turned into a detailed examination of the biopsied lymph node(s) and subsequent rise in the incidence of finding lymph node micrometastases. Micrometastases(pN1mi) is defined as a metastatic disease in the lymph node that is less than 2.0 mm but larger than 0.2mm. Isolated tumor cells (ITC) is defined as a metastatic disease in the lymph node that is smaller or equal to 0.2mm. With the rise of incidence of axillary micrometastases, there is a considerable debate on the prognostic significance and appropriate treatment recommendations for such patients.
Triple negative (TNBC) metastatic breast cancer is a heterogeneous disease, chemotherapy remains the mainstay of treatment, however, new treatments based on identifying molecular subtypes, stratifying TNBC based on gene expression assays with subsequent specific targeted therapy is an area of intense clinical research. In this post, I will review our current standard clinical practice and explore ongoing and future clinical directions.
Metastatic TNBC is very heterogenous, and while Basal type is most common, it only account for nearly 80% of all cases.
Luminal estrogen receptor positive HER-2 negative breast cancer is the common type of breast cancer, accounting for 70% of all breast cancer. Endocrine therapy of estrogen receptor positive HER2 negative advanced breast cancer is very effective, however, many patients will have disease recurrence as a result of endocrine therapy emerging resistance. In this post, I will review our recent understanding of resistance mechanisms how this understanding translating into new therapies.