“Overall, patients who received trastuzumab deruxtecan remained on treatment longer, had higher objective response rates [ORRs], and longer duration of response, progression-free survival [PFS], and overall survival [OS]” than those given capecitabine plus either trastuzumab or lapatinib, write the researchers in The Lancet .

Results Of the 3609 Italian reports, 65.6% were related to trastuzumab ( n  = 2367), followed by pertuzumab, TDM-1, and lapatinib.

Supplementing capecitabine with neratinib instead of lapatinib is associated with a significant improvement in the progression-free survival of previously treated patients with metastatic HER2-positive breast cancer, shows the phase 3 NALA trial.

Combining pyrotinib instead of lapatinib with capecitabine is associated with significantly improved progression-free survival in patients who have received prior treatment for HER2-positive metastatic breast cancer, show phase 3 trial data.

In EMILIA , median overall survival (OS) was 29.9 months for the 495 previously treated patients with locally advanced or metastatic disease who were randomly assigned to receive the antibody–drug conjugate and 25.9 months for their 496 counterparts given capecitabine plus lapatinib.

They conducted a post hoc analysis of the ALTTO trial, which had been conceived to evaluate lapatinib in the adjuvant setting, and included 8381 patients, of whom 2.2% had not received metformin for diabetes and 3.1% had.

They also detected amplifications involving the CD274 and PDCD1LG2 genes, which code for the immune checkpoint proteins PD-L1 and PD-L2, respectively, and BCAR4 , a long noncoding RNA that promotes metastasis in breast cancer via the HER2/3 pathway and can be targeted indirectly by lapatinib.