Your AI-Trained Oncology Knowledge Connection!
Heather McArthur, MD, MPH, FASCO, is the Clinical Director of Breast Cancer and Komen Distinguished Chair in Clinical Breast Cancer Research at University of Texas Southwestern (UTSW) Medical Center.
In their discussion, medical experts in the field of breast cancer explore the role of liquid biopsies and compare the significance of ESR1 mutations to other biomarkers, such as PIK3CA, in terms of their driver versus passenger status in the context of HR+/HER2- breast cancer.
The key opinion leaders (KOLs) review the current testing methods for detecting ESR1 mutations and explore the existing strategies employed to overcome or delay the development of these mutations and the associated endocrine resistance in patients with HR+/HER2- metastatic breast cancer.
Virginia Kaklamani, MD, DSc, and Heather McArthur, MD, explore the clinical significance of *ESR1* mutations in HR+/HER2- metastatic breast cancer patients, including their impact on disease prognosis, treatment outcomes, and the increasing prevalence of these mutations with each line of endocrine therapy, ultimately informing their therapeutic approach.
Key opinion leaders anticipate future developments in HER2-positive breast cancer, and on the potential for translating therapeutic advances from the metastatic landscape into early-stage disease management.
Medical experts delve into the challenges of brain metastases in HER2-positive breast cancer, exploring local therapies for targeting central nervous system metastases and emphasizing the crucial role of multidisciplinary tumor boards, collaboration with colleagues, and referrals to specialized providers in optimizing patient outcomes.
Key opinion leaders revisit the HER2CLIMB trial, providing an in-depth analysis of the latest updates and their implications for the management of HER2-positive metastatic breast cancer.
Vijayakrishna Gadi, MD, PhD, presents the case of a 54-year-old woman with HER2-positive metastatic breast cancer exhibiting bone, liver, and brain lesions, and key opinion leaders share their perspectives on the most appropriate treatment approaches tailored to the patient's specific disease characteristics and metastatic sites.
Vijayakrishna Gadi, MD, PhD, shares his insights on managing patients with HER2-positive metastatic breast cancer who have progressed on second and third-line treatments, stressing the potential benefits of incorporating small molecules, tyrosine kinase inhibitors (TKIs), chemotherapy, and enrolling patients in clinical trials to optimize outcomes.
Tiffany A. Traina, MD, addresses adverse event monitoring and the range of adverse events patients may experience with front-line treatments for HER2-positive metastatic breast cancer, particularly highlighting alopecia and diarrhea as common side effects.
Key opinion leaders explore various therapeutic options for later-line treatment of HER2-positive metastatic breast cancer, emphasizing the significance of the HER2CLIMB and CLEOPATRA trials, while also drawing comparisons to real-world data to inform clinical decision-making.
Tiffany A. Traina, MD, presents a patient case involving a woman diagnosed with HR-negative, HER2 3+ invasive ductal adenocarcinoma and elaborates on the clinical management approaches employed in her treatment sequencing.
Heather McArthur, MD, emphasizes the influence of recent and ongoing clinical trials, specifically DESTINY-Breast09 and HER2CLIMB-05, in steering the treatment paradigm in 1st-line HER2-positive metastatic breast cancer.
Medical experts examine the current standards of care and successive lines of treatment for HER2-positive metastatic breast cancer, while also addressing the challenges encountered in managing this complex disease.
Tiffany A. Traina, MD; Vijayakrishna Gadi, MD, PhD, and Heather McArthur, MD, underscore the importance of testing all early-stage and breast cancer patients for HER2 positivity to inform and guide optimal therapeutic decision-making.
Heather Lynn McArthur, MD, MPH, discusses the primary results from the phase 3 KEYNOTE-756 study of neoadjuvant pembrolizumab plus chemotherapy in early-stage, high-risk, estrogen receptor–positive, HER2-negative breast cancer.
Panelists wrap up their discussion on HER2+ breast cancer by summarizing the most exciting recent advances in the field and their hopes for the future of treatment.
Dr Kaklamani presents a profile of a patient with HER2+ breast cancer and liver metastases who had disease progression after first-line chemotherapy and a solitary new brain metastasis after second-line T-DM1.
Melinda L. Telli, MD, presents a profile of a patient with early stage breast cancer with residual nodal disease after neoadjuvant chemotherapy and surgery, whose tumor was initially HER2+ but became triple-negative after treatment.
Virginia G. Kaklamani, MD, DSc, presents a patient profile of early stage HER2+ breast cancer with residual nodal disease after neoadjuvant chemotherapy and surgery.
Experts share their go-to regimens in the third-line and higher setting of HER2+ metastatic breast cancer, and touch on the factors that support their decision-making.
Debu Tripathy, MD, discusses novel therapies being developed for later-line treatment of HER2+ mBC.
Drs McArthur and Telli discuss recent data updates from the DESTINY-Breast trials of T-DXd, including a pooled analysis, and share best practices for monitoring patients for lung complications.
Drs Tripathy and Kaklamani emphasize the most critical unmet needs for patients with HER2+ metastatic breast cancer in the third-line or higher settings and recap what the field previously learned from the HER2CLIMB trial of tucatinib/trastuzumab/capecitabine.
Panelists briefly touch on ongoing trials of second-line tucatinib combination therapy, including HER2CLIMB-02 and HER2CLIMB-05, in patients with or without brain metastases, and offer their clinical perspective which second-line regimens they typically recommend for their patients with HER2+ mBC.
Experts introduce the antibody-drug conjugates (ADCs) trastuzumab emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd) and discuss clinical trial findings and potential use in special patient populations, such as those with brain metastases.
Drs McArthur and Kaklamani expand upon the standard-of care regimens used for first-line treatment of patients with HER2+ metastatic breast cancer (mBC), review clinical data supporting their use, and share excitement for upcoming data readouts on novel regimens in the space.
Panelists discuss recent data updates on standard-of-care and emerging regimens for adjuvant treatment of HER2+ eBC, including data presented at the 2023 ASCO meeting, and highlight exciting trials in progress that have not yet read out.
Drs Tripathy and McArthur touch on the use of extended adjuvant therapy with neratinib and identify patients who might be suitable for this regimen, including those high-risk patients with residual disease after neoadjuvant therapy.
Virginia G. Kaklamani, MD, DSc, and Melinda L. Telli, MD, review the various adjuvant therapy options available for patients with HER2+ early breast cancer based on stage, risk status, and whether or not they had received neoadjuvant therapy, and then touch on clinical data supporting the use of fixed-dose pertuzumab/trastuzumab (PH) in this setting.
Dr Tripathy provides clinical insight on how he assesses HER2+ eBC patient response to neoadjuvant therapy, discusses the typical prognosis for those who do or do not have residual disease, and touches on how he might approach adjuvant treatment selection for each.
