Overview of the CLEOPATRA Trial: Implications for Advanced Practitioners
نویسنده
چکیده
G enomic biomarkers have long been known as predictors of pharmacokinetic differences among individuals that lead to differences in plasma drug exposure. Overexpression of the human epithelial growth factor receptor (HER2) proto-oncogene is seen in about 25% of human breast cancer and leads to a more aggressive tumor phenotype with a poor prognosis (Rexer & Arteaga, 2012). In recent years, this protein has become an important biomarker and a target for breast cancer treatment. Trastuzumab (Herceptin), a monoclonal antibody against the HER2 receptor, was the first major breakthrough in the treatment of HER2-positive breast cancer (Oliveira, Braga, Passos-Coelho, Fonseca, & Oliveira, 2011). Monoclonal antibodies activate immune effectors to kill tumor cells through complement cascade or antibody-dependent cellular cytotoxicity (Shuptrine, Surana, & Weiner, 2012). Another effective monoclonal antibody is pertuzumab (Perjeta). Dual targeting with the monoclonal antibodies pertuzumab and trastuzumab plus chemotherapy was shown to increase median survival in the recently published Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) trial in the setting of HER2-positive metastatic breast cancer.
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