Second line trastuzumab emtansine following horizontal dual blockade in a real-life setting

// Salvatore Del Prete 1 , Liliana Montella 2 , Grazia Arpino 3 , Giuseppe Buono 3 , Carlo Buonerba 3 , Pasquale Dolce 4 , Olga Fiorentino 5 , Maria Aliberti 5 , Antonio Febbraro 6 , Clementina Savastano 7 , Giuseppe Colantuoni 8 , Ferdinando Riccardi 9 , Angela Ruggiero 2 , Sabino De Placido 3 and Michele Orditura 10 1 Medical Oncology Unit “San Giovanni di Dio” Hospital, Frattamaggiore, Naples 80027, Italy 2 Medical Oncology Unit “Santa Maria delle Grazie” Hospital, Pozzuoli, Naples 80078, Italy 3 Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples 80131, Italy 4 Department of Public Health, University of Naples Federico II, Naples 80131, Italy 5 Medicina Futura Group, via Alcide de Gasperi, Acerra, Naples 80011, Italy 6 Medical Oncology Unit, Hospital Sacro Cuore di Gesù Fatebenefratelli, Benevento 82100, Italy 7 Medical Oncology Unit, San Giovanni di Dio e Ruggi d’Aragona, Salerno 84121, Italy 8 Medical Oncology Unit, San Giuseppe Moscati Hospital, Avellino 83100, Italy 9 Medical Oncology Unit, Antonio Cardarelli Hospital, Napoli 80131, Italy 10 Division of Medical Oncology, Department of Precision Medicine, School of Medicine, University of Study of Campania “Luigi Vanvitelli”, Naples 80131, Italy Correspondence to: Salvatore Del Prete, email: salvatore.delprete@aslnapoli2nord.it Liliana Montella, email: liliana.montella@aslnapoli2nord.it Keywords: breast cancer; metastatic; Her-2 positive; trastuzumab emtansine; pertuzumab Received: March 14, 2020     Accepted: April 27, 2020     Published: June 02, 2020 ABSTRACT Despite relevant medical advancements, metastatic breast cancer remains an uncurable disease. HER2 signaling conditions tumor behavior and treatment strategies of HER2 expressing breast cancer. Cancer treatment guidelines uniformly identify dual blockade with pertuzumab and trastuzumab plus a taxane as best first line and trastuzumab emtansine as preferred second line choice. However, there is no prospectively designed available study focusing on the sequence and outcomes of patients treated with T-DM1 following the triplet. In the following report, data concerning a wide series of patients treated in a real-life setting are presented. Results obtained in terms of response and median progression free survival suggests a significant role for T-DM1 in disease control of metastatic HER2 expressing breast cancer.