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Trials of Adjuvant Trastuzumab in HER2+ Early-Stage Breast Cancer. With permission from Hudis CA. N Engl J Med. 2007;357:39-51. ALTTO Formerly Known as APHRODITE. Inclusion Criteria • HER2+ breast cancer • ≥4 cycles anthracycline-based neoadjuvant chemotherapy • LVEF ≥50%.
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Trials of Adjuvant Trastuzumab in HER2+ Early-Stage Breast Cancer With permission from Hudis CA. N Engl J Med. 2007;357:39-51.
ALTTO Formerly Known as APHRODITE Inclusion Criteria • HER2+ breast cancer • ≥4 cycles anthracycline-based neoadjuvant chemotherapy • LVEF ≥50% Trastuzumab x 1 year Lapatinib x 1 year Randomize Trastuzumab x 1 year + lapatinib x 1 year Trastuzumab x 12 weeks Break 6 weeks Lapatanib x 34 weeks Clinicaltrials.gov. Available at: http://www.clinicaltrials.gov/ct2/show/NCT00490139?term=A.Accessed on: September 15, 2009. ALLTOTRIALS.COM—Trial Overview. Available at: http://www.alttotrials.com/patients.php#5. Accessed on: September 15, 2009.
Refine Antibodies Targeting HER2+ Tumors Inhibit Dimerization Moderate Receptor Expression Inhibit Kinase Activity Potentiate Downstream Effects With permission from Burstein HJ. N Engl J Med. 2005;353:1652-1654.
Mechanism of Cell Death from Inhibition of Polyadenosine Diphosphate-Ribose Polymerase 1 (PARP-1) With permission from Iglehart JD, et al. N Engl J Med. 2009;361:189-191.
Radiologic Evidence of Tumor Response to Olaparib A Patient 20at Baseline Patient 20at 4 Months Patient 41at Baseline Patient 41at 4 Months With permission from Fong PC, et al. N Engl J Med. 2009;361:123-134.
BevacizumabSummary of Breast Cancer Studies 1. Miller KD, et al. J Clin Oncol. 2005;23:792-799. 2. Miles D, et al. 44th ASCO; May 30-June 3, 2008. Abstract LBA1011. 3. Miller K, et al. N Engl J Med. 2007;357:2666-2676. 4. Robert NJ, et al. 45th ASCO; May 29-June 2, 2009. Abstract 1005.
VEGF Signaling Pathway in Angiogenesis With permission from Kerbel RS. N Engl J Med. 2008;358:2039-2049.
NSABP B-20 Outcomeby Recurrence Score Overall Low risk: <18 Intermediate risk: 18–30 High risk: >30 With permission from Paik S, et al. J Clin Oncol. 2006;24:3726-3734.
Oncotype DX Breast Cancer Assay • Oncotype DX recurrence score tends to correlate with established breast cancer prognostic/predictive factors • Age • Tumor grade • HER2 • Quantitative ER/PR levels • Tumor size • The “poor man’s” Oncotype DX • TN stage, grade, ER, PR, HER2 Oncotype DX, Breast Cancer Assay. Available at: www.oncotypedx.com. Accessed on: September 14, 2009.
Multigene Arrays and Prediction of Relapse-Free Survival in Breast Cancer With permission from Fan C, et al. N Engl J Med. 2006;355:560-569.