This treatment is usually for people whose breast cancer has spread to in the armpit and has a high risk of coming back (recurrence). Your breast cancer must also be and .
Alpelisib is a type of targeted drug. It’s for people who have or secondary breast cancer and the cancer:
is
is
has changes (mutation) in the gene known as PIK3CA
has come back (recurred) after having a type of drug called a CDK4/6 inhibitor (for example abemaciclib, palbociclib, or ribociclib) with hormone therapy treatment
You may have alpelisib with a hormone therapy called fulvestrant. Your doctor will tell you more about this treatment and if it’s available to you.
Capivasertib is a type of targeted treatment called a cancer growth blocker. You pronounce capivasertib as cap-ih-ver-sir-tib.
It is a treatment for some people with breast cancer that has spread to the surrounding tissue (locally advanced). Or if it has spread to other parts of the body (secondary breast cancer).
It is for people whose breast cancer is and negative.
The cancer must also have one or more of the following :
PIK3CA
AKT1
PTEN
To have capivasertib your cancer must have come back or not gone away after treatment with both of the following:
an such as anastrozole, exemestane or letrozole
a type of cancer growth blocker called a cyclin dependant kinases (CDK) inhibitor. These are the drugs abemaciclib, palbociclib or ribociclib
You have capivasertib with a hormone treatment called fulvestrant.
Denosumab is a type of targeted drug called a .
When cancer spreads to the bones it can cause pain and weaken them. Your doctor may suggest you have denosumab. It can strengthen the bones, lower the risk of fractures and help to control pain.
Everolimus is a type of cancer growth blocker. It stops some cancer cells from dividing and growing.
You might have everolimus if you have secondary breast cancer that is and . You have this drug if you are past the menopause (post menopausal). You take it with a hormone therapy drug called exemestane.
Your doctor might suggest palbociclib if you have locally advanced breast cancer. This means that the cancer has spread into the surrounding area such as the .
It is for people who have and breast cancer.
You usually have palbociclib in combination with hormone therapy such as anastrozole.
Pembrolizumab is a type of immunotherapy. It is a possible treatment for people with
You usually have pembrolizumab with chemotherapy before surgery (neo adjuvant treatment). This is to reduce the size of the cancer before surgery. You then continue to have it on its own after your surgery (adjuvant treatment).
Sacituzumab govitecan is a type of targeted drug. It’s for people with breast cancer that has spread to surrounding tissue (locally advanced). Or for people whose cancer has spread to other parts of the body (secondary breast cancer) and is:
Talazoparib is a type of targeted drug called a .
It’s for people with breast cancer who have an abnormal change (mutation) in the or genes.
You might have this if your breast cancer has spread to surrounding tissue (locally advanced). Or if it has spread to other parts of the body (secondary breast cancer).
To have talazoparib you usually must already have had:
hormone therapy for breast cancer
a type of chemotherapy called an or or both
You might be able to have talazoparib if you were unable to have the treatments above.
This treatment is made up of 2 drugs, trastuzumab and deruxtecan.
You might have this if you have breast cancer that:
cannot be removed by surgery (unresectable) or
has spread to other parts of the body (secondary breast cancer)
It's for people who have already had treatment for HER2 positive breast cancer.
Some people with breast cancer that has low levels of HER2 (HER2 low breast cancer) may have trastuzumab deruxtecan for unresectable or secondary breast cancer, if they have already had chemotherapy. Or if the cancer has come back during chemotherapy, or within 6 months of finishing it. This is available on the NHS in Scotland. But it hasn't been approved for use on the NHS in England, Wales and Northern Ireland.
Trastuzumab emtansine (Kadcyla) is a combination of 2 drugs:
trastuzumab
a chemotherapy drug called emsatine
It is a treatment for HER2 positive after surgery. It is only for people who had drug treatment before surgery. And when they had the operation the surgeon found cancer cells nearby either in the breast or lymph nodes.
Trastuzumab emtansine works by finding and attaching itself to the HER2 protein on the surface of the cancer cell. The emtansine then goes inside the cancer cell to destroy it.
Having targeted cancer drugs and immunotherapy treatment
You have your treatment as tablets or capsules or as a dip into your bloodstream. This depends on the type of drug you have.
Taking your tablets or capsules
You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Talk to your healthcare team before you stop taking a cancer drug, or if you have missed a dose.
Drip into your bloodstream
You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment. This means your doctor or nurse won't have to put in a cannula every time you have treatment.
Research
Researchers are looking at new and different types of targeted and immunotherapy drugs for breast cancer.
They are also looking into different combinations. This includes combining them with chemotherapy or other types of drugs. They want to find out if they improve how well they work.
Early and locally advanced breast cancer: diagnosis and management
National Institute for Health and Care Excellence (NICE), 2018. Last updated June 2023
Early Breast Cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
F Cardoso and others
Annals of Oncology, 2019. Vol 30, issue 8. Pages 1194-1220
Updated UK Recommendations for HER2 assessment in breast cancer
E A Radha and others
Journal of Clinical Pathology, 2015. Volume 68, PAges 93 -99
The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.
