Javier Cortés, director of the International Breast Cancer Center (IBCC).
The approach inside HER2 positive metastatic breast cancer initiated a paradigm shift thanks to drugs trastuzumab deruxtecan. One of the main authors of this milestone is Javier Cortesfounder and director of the International Breast Cancer Center (IBCC) and first signatory of the Destiny-Breast-03 clinical trial, which demonstrated that the drug slows the progression of metastatic breast cancer and multiplies survival. Following the approval of the price and funding by the Interministerial Commission on Drug Prices (CIPM), the drug is now available in Spain for the treatment of this type of cancer and it is estimated that approximately 1,200 patients will be eligible for this funding.
The oncologist marked the 45th Annual Breast Cancer Symposium on her calendar Sant ‘Antonio, an appointment that will be held from 6 to 10 December and in which the overall survival data of the drug will be revealed in this type of breast cancer and against brain metastases with low HER2 expression. “These are very positive data in both pathologies, which significantly increase survival. An unprecedented path of treatment opens up for these patients”, announces the specialist in Medical writing.
On the other hand, and after the good results offered by the study the fate sine-03, the IBCC has initiated “new avenues of negotiation” to undertake new studies in the area of cancer, with the aim of continuing to improve on the results obtained to date. “We must learn to combine trastuzumab deruxtecan with other drugs such as immunotherapy in the context of triple negative breast cancer with low expression of HER2”, confirms the specialist.
How important are the latest advances in HER2-positive metastatic breast cancer?
I think they are extremely relevant for three reasons. With new treatments we can control HER2-positive breast cancer for much longer and this reality translates into increased survival in studies.
On the other hand, people are living longer with these treatments and with new advances we have cracked down and we continue to improve.
Finally, in addition to improving survival, many patients see how their tumor can even disappear. Now, the question we have to ask is whether we are on the verge of a cure for patients with HER2-positive metastatic breast cancer.
What has the European approval of trastuzumab deruxtecan in unresectable or metastatic HER2-positive breast cancer meant for patients and professionals?
The drug was approved in January 2021, and asking that question now has a bittersweet answer. The positive part is the approval of a drug. And the bitter aspect is that there are patients to whom it cannot be administered today because they are no longer with us or because their current condition is negative.
The Interministerial Commission on the Prices of Medicines (CIPM) agreed to finance the National Health System of trastuzumab deruxtecan for metastatic breast cancer. Is this a breakthrough in the approach to this pathology in Spain?
This is one of the most important drugs in the history of cancer in general, and in breast it is the most active that we have seen. We have been waiting for this approval like rain in May. We are very excited to be able to give this drug to patients, but with the bitter feeling that we have not given it before.
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“San Antonio to establish drug as standard treatment for significant number of patients” |
What is the drug’s impact on overall survival for this disease and for brain metastases with low HER2 expression?
This information will be revealed at the 45th Annual Breast Cancer Symposium in San Antonio on December 6. Nonetheless, I can anticipate that there are positive data and that survival is increased in HER2-positive breast cancer.
On the other hand, in brain metastases, the data obtained offer great hope, as they are the first to appear for this uncontrolled and unstable disease with progression. An unprecedented avenue of treatment opens up for these patients.
Will the next San Antonio Breast Cancer Symposium mark a before and after in the approach to this disease with the results achieved?
This before and after should have happened before, now it is possible to consolidate. It is a point and followed. We have more tools to reclaim what we’ve been saying for a long time. This drug is standard treatment for a significant number of patients.
After the published results of Destiny Breast-03, what are the next steps to take?
Trastuzumab deruxtecan should be moved into older lines, to see if we can even improve the results seen when given before the disease. We need to learn to combine it with other drugs such as immunotherapy in the context of triple negative breast cancer with low HER2 expression. I think the most important thing is that we need to start more strategic trials now to offer more treatments to patients who need it and except of those in which it may be sufficient.
Are there any plans to start new breast cancer trials?
We are currently negotiating to open new studios in this area, although they are not closed yet.
How important was Spain’s participation in the Destiny Breast-03 study?
Our country has participated in the vanguard of medicine related to oncology. It is a source of pride and prestige for all the hospitals that have been able to observe how this drug was started before its approval and is giving good results.
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“Spain has participated in the vanguard of medicine related to oncology” |
What benefits have been confirmed for other types of cancers than breast?
It is approved in the US and Europe for patients with lung cancer and is having very positive results in gastric cancer.
Has trastuzumab deruxtecan changed the paradigm of breast cancer management so far?
Of course, the importance of innovation is demonstrated here and we hope the drug reaches its regulatory status as soon as possible.
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