You are here

Anti-HER2 targeted treatments in the Elderly with Breast Cancer

Background
During the past decade, HER2+ breast cancer patients have greatly benefited from the development of specific treatments targeting the HER2 receptor (monoclonal antibodies, tyrosine kinase inhibitors TKI, conjugates, etc.): the pioneer trastuzumab followed shortly by the tyrosine kinase inhibitor lapatinib, and the recently launched trastuzumab-emtansine best exemplify this move.

There are different processes related to aging which imply specifying monitoring of these treatments in the elderly patients, when given either alone, in combination according to the concept of multi-HER2 blockade, or in association with endocrine or cytotoxic agents. Stakes and issues may differ compared with younger patients. The Task Force will evaluate these questions and give expert position paper adapted for various types of anti-HER2 agents currently available or in development.

These expert position paper will also take into account already published SIOG expert position paper and others specifically on breast cancer and methodology of clinical trials:
End Points and Trial Design in Geriatric Oncology Research: A Joint European Organization for Research and Treatment of Cancer–Alliance for Clinical Trials in Oncology–International Society of Geriatric Oncology (Position Article) Hans Wildiers, Murielle Mauer, Athanasios Pallis, Arti Hurria, Supriya G. Mohile, Andrea Luciani, Giuseppe Curigliano, Martine Extermann, Stuart M. Lichtman, Karla Ballman, Harvey Jay Cohen, Hyman Muss, and Ulrich Wedding J Clin Oncol 31. © 2013 by American Society of Clinical Oncology Published Ahead of Print on September 9, 2013 as 10.1200/JCO.2013.49.6125
 
Aims
To review the available evidence showing that anti-HER2 treatments administration in HER2+ breast cancer can be administered safely to older patients with the same level of benefits as in younger patients.

Task Force Members 

Moderators
Etienne Brain, France & Hans Wildiers, Belgium

Writing Committee
Laura Biganzoli, Italy
Philippe Caillet, France
Karis Cheng, Singapore
Lissandra Dal Lago, Belgium
Nienke de Glas, the Netherlands

2017 03 - the manuscript was submitted to JAMA Oncology.

HER2 targeted treatment for elderly patients with breast cancer: position paper of a SIOG Task Force
Human epidermal growth factor receptor-positive (HER2+) breast cancer (BC) is less frequent in older patients than in their younger counterparts but still represents 10-15% of cases. Many elderly patients have cardiovascular risk factors or comorbidity, and HER2-directed therapy is potentially cardiotoxic. The treatment of HER2+ BC in the elderly therefore requires careful consideration. This is especially so given the limited guidance available from pivotal trials which include few patients aged over 65 years.

This project is supported by an unrestricted grant from Roche.