Algoritmo de tratamiento en CMM HER2+
First-line**
Taxane + T + pertuzumab
T-DM1
Second-line
T-DM1
Lapatinib + capecitabine
Third-line
Lapatinib + capecitabine
Lapatinib + trastuzumab*
Fourth-line
Lapatinib + trastuzumab*
Trastuzumab + chemotherapy
Trastuzumab (T)-naïve or
T-’sensitive’ population
(adj. T-free interval ≥6-12
months)
Trastuzumab (T)-pretreated
and doubt about T-’sensitivity’
(adj. T-free interval <6-12
months)
*For ER-negative disease
** Consider Hormonal therapy + antiHER2 in selected patients
