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Targeted Therapies and Immunotherapies for Metastatic Breast Cancer

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Targeted therapies are treatments that target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Targeted therapies are generally less likely than chemotherapy to harm normal, healthy cells. Some targeted therapies are antibodies that work like the antibodies made naturally by our immune systems. Because of this, they are sometimes called “immune targeted therapies.”

Immunotherapy medicines use the power of your body’s immune system to attack cancer cells.

There are a number of targeted therapies doctors use to treat metastatic breast cancer:

Afinitor (chemical name: everolimus) is used in combination with Aromasin (chemical name: exemestane) to treat advanced-stage, hormone-receptor-positive, HER2-negative breast cancer in postmenopausal women that has already been treated with Femara (chemical name: letrozole) or Arimidex (chemical name: anastrozole). Afinitor is a pill taken by mouth.

Avastin (chemical name: bevacizumab) is given intravenously in combination with the chemotherapy medicine Taxol (chemical name: paclitaxel) to treat people diagnosed with metastatic, HER2-negative breast cancer who haven't yet received chemotherapy for metastatic breast cancer. In 2011, the U.S. Food and Drug Administration (FDA) removed the breast cancer approval from Avastin because the drug has not been shown to be safe and effective for that use. Avastin has not been removed from the market, though, and doctors can choose to use Avastin to treat metastatic breast cancer whether or not that particular use is officially approved by the FDA.

Enhertu (chemical name: fam-trastuzumab-deruxtecan-nxki) is approved to treat HER2-positive breast cancer that can’t be removed with surgery and metastatic HER2-positive breast cancer that has been treated with two or more anti-HER2 therapies. Enhertu is given intravenously, which means the medicine is delivered directly into your bloodstream through an IV or port.

Herceptin (chemical name: trastuzumab) is used to treat metastatic, HER2-positive breast cancer. One form of Herceptin is given intravenously and another is given as injection under the skin. There are also several Herceptin biosimilars, medicines that are highly similar to Herceptin and may be prescribed instead of Herceptin.

Ibrance (chemical name: palbociclib) works against locally advanced-stage or metastatic, estrogen-receptor-positive, HER2-negative breast cancer in postmenopausal women who have never taken hormonal therapy. Ibrance is a pill taken by mouth.

Jemperli (chemical name: dostarlimab-gxly) is used to treat mismatch repair deficient (dMMR) advanced-stage breast cancer that has grown during or after treatment if no other treatment options are available. Fewer than 1% of breast cancers have the dMMR biomarker.

Kadcyla (chemical name: T-DM1 or ado-trastuzumab emtansine) is used to treat HER2-positive, locally advanced or metastatic breast cancer that’s previously been treated with Herceptin and a type of chemotherapy medicine called a taxane. Kadcyla is a combination of Herceptin and the chemotherapy medicine emtansine and is given intravenously through an IV or port.

Kisqali (chemical name: ribociclib, formerly called LEE011) can be used in combination with an aromatase inhibitor to treat women diagnosed with metastatic, hormone-receptor-positive, HER2-negative breast cancer that hasn’t been treated with hormonal therapy yet. Kisqali can also be used in combination with Faslodex (chemical name: fulvestrant) in postmenopausal women diagnosed with metastatic, hormone-receptor-positive, HER2-negative breast cancer that either hasn’t been treated with hormonal therapy yet, or has grown during treatment with a different hormonal therapy. Kisqali is a pill taken by mouth.

Lynparza (chemical name: olaparib) is used to treat metastatic, HER2-negative breast cancer with an inherited BRCA1 or BRCA2 mutation that has previously been treated with chemotherapy. Lynparza is a pill taken by mouth.

Margenza (chemical name: margetuximab-cmkb) is used in combination with chemotherapy to treat people diagnosed with metastatic HER2-positive breast cancer who have been treated previously with two or more anti-HER2 regimens, at least one of which was for metastatic disease. Margenza is given intravenously, which means it’s delivered directly into your bloodstream through an IV or a port.

Nerlynx (chemical name: neratinib) is used in combination with the chemotherapy medicine Xeloda (chemical name: capecitabine) to treat advanced-stage and metastatic HER2-positive breast cancer in people who have already been treated with at least two HER2 inhibitors for advanced-stage disease. Nerlynx is a pill taken by mouth.

Perjeta (chemical name: pertuzumab) is used in combination with Herceptin and the chemotherapy medicine Taxotere (chemical name: docetaxel) to treat HER2-positive metastatic breast cancer that hasn’t been treated with either Herceptin or chemotherapy yet. Perjeta is given intravenously.

Phesgo (chemical name: pertuzumab, trastuzumab, and hyaluronidase-zzxf) is a fixed-dose combination of Herceptin, Perjeta, and hyaluronidase-zzxf used in combination with Taxotere to treat HER2-positive metastatic breast cancer that has not been treated with an anti-HER2 therapy or chemotherapy. Phesgo is given as an injection under the skin in the thigh.

Piqray (chemical name: alpelisib) is used in combination with the hormonal therapy Faslodex to treat advanced-stage or metastatic hormone-receptor-positive, HER2-negative breast cancer with a PIK3CA mutation that has grown after treatment with hormonal therapy in postmenopausal women and men. Piqray is a pill taken by mouth.

Talzenna (chemical name: talazoparib) is used to treat locally advanced or metastatic HER2-negative breast cancer with an inherited BRCA1 or BRCA2 mutation. Talzenna is a pill taken by mouth.

Trodelvy (chemical name: sacituzumab govitecan-hziy) is approved to treat women and men diagnosed with unresectable locally advanced or metastatic triple-negative breast cancer who have received two or more systemic therapies (such as chemotherapy or targeted therapy), at least one of which was for advanced-stage disease. Trodelvy is given intravenously through an IV or port.

Tukysa (chemical name: tucatinib) is used in combination with Herceptin and Xeloda to treat metastatic HER2-positive breast cancer or locally advanced HER2-positive breast cancer that can’t be completely removed with surgery, after the cancer has been treated with at least one anti-HER2 medicine.

Tykerb (chemical name: lapatinib) is given in combination with Xeloda to treat locally advanced or metastatic HER2-positive breast cancer that has stopped responding to anthracyclines, taxanes, and Herceptin. Tykerb can also be given in combination with Femara to treat advanced-stage, HER2-positive, hormone-receptor-positive breast cancer. Tykerb is a pill taken by mouth.

Verzenio (chemical name: abemaciclib) is used in combination with an aromatase inhibitor as the first hormonal therapy to treat advanced-stage or metastatic, hormone-receptor-positive, HER2-negative breast cancer in postmenopausal women. Verzenio also is used in combination with Faslodex to treat hormone-receptor-positive, HER2-negative metastatic or advanced-stage breast cancer if the cancer grew after hormonal therapy treatment. Premenopausal and perimenopausal women who take Verzenio in combination with Faslodex also should be treated with a medicine to suppress ovarian function. Verzenio is used alone to treat hormone-receptor-positive, HER2-negative metastatic or advanced-stage breast cancer if the cancer grew after hormonal therapy treatment and earlier chemotherapy for metastatic disease.

For more information on targeted therapies used to treat metastatic breast cancer, including side effects and what to expect, visit the Targeted Therapies section.  

The immunotherapy medicine Keytruda (chemical name: pembrolizumab) is approved by the FDA to treat metastatic breast cancer.

Keytruda is used in combination with chemotherapy to treat unresectable locally advanced or metastatic triple-negative, PD-L1-positive breast cancer. Unresectable means that it can’t be removed with surgery.

For more information on immunotherapies used to treat metastatic breast cancer, including side effects and what to expect, visit the Immunotherapy section.


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