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    Association details:
    Biomarker:HER-2 positive
    Cancer:HER2 Positive Breast Cancer
    Drug:Herceptin (trastuzumab) (HER2 inhibitor) +
    Verzenio (abemaciclib) (CDK4 inhibitor, CDK6 inhibitor)
    Direction:Sensitive
    Evidence:
    Evidence Level:
    Sensitive: A2 - Guideline
    Source:
    ASCO.org
    Title:

    Systemic Therapy for Advanced Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer: ASCO Guideline Update

    Published date:
    05/31/2022
    Excerpt:
    If a patient's HER2-positive advanced breast cancer has progressed during or after second-line or greater HER2-targeted treatment...Recommendation…May offer abemaciclib combined with trastuzumab and fulvestrant…
    Secondary therapy:
    fulvestrant
    DOI:
    10.1200/JCO.22.00519
    Evidence Level:
    Sensitive: C3 – Early Trials
    Source:
    ESMO 2022
    Title:

    LBA18 - Final overall survival (OS) for abemaciclib plus trastuzumab +/- fulvestrant versus trastuzumab plus chemotherapy in patients with HR+, HER2+ advanced breast cancer (monarcHER): A randomized, open-label, phase II trial

    Published date:
    09/05/2022
    Excerpt:
    Median follow-up was 52.9 months. mOS was 30.3 months in arm A, 31.43 months in arm B and 22.7 months in arm C (A v C: HR 0.75 [95% CI 0.47, 1.21]; nominal 2-sided p-value 0.243; B v C: HR 0.73 [95% CI 0.46, 1.15]; nominal 2-sided p-value 0.177). In exploratory RNAseq analyses, luminal subtypes were associated with longer PFS (8.6 v 5.4 months [HR 0.54, 95% CI 0.38, 0.79]) and OS (31.7 v. 19.7 months [HR 0.68, 95% CI 0.46, 1]) compared to non-luminal. Updated PFS and safety findings were consistent with the primary analysis (data cutoff 8 Apr 2019). Abemaciclib plus trastuzumab ± fulvestrant numerically improved OS in women with HR+, HER2+ ABC compared to chemotherapy plus trastuzumab with a manageable safety profile.
    Secondary therapy:
    fulvestrant
    Trial ID:
    monarcHER
    Evidence Level:
    Sensitive: C3 – Early Trials
    Source:
    Pharmacy Times
    Title:

    Combination Therapy Significantly Improved Progression-Free Survival in Patients with HER2-Positive Breast Cancer

    Published date:
    05/01/2020
    Excerpt:
    The combination of abemaciclib, fulvestrant, and trastuzumab showed significant improvement in progression-free survival (PFS) versus standard-of-care chemotherapy plus trastuzumab....in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer.
    Secondary therapy:
    fulvestrant