Kandace McGuire, MD

Panelists discuss how genomic assays have become essential tools in modern breast cancer treatment, preventing overtreatment by enabling customized treatment plans that determine not only whether patients need chemotherapy but also which specific agents they should receive and whether treatment should be given before or after surgery.

Panelists discuss how genomic testing informs real clinical scenarios, demonstrating that for a 64-year-old healthy woman with a single positive lymph node, the 21-gene assay would guide treatment decisions, with cardiac assessment influencing whether anthracycline-based chemotherapy would be used if her score was high.

Panelists discuss how the TAILORx trial data were transformative for estrogen receptor–positive breast cancer by establishing clearer thresholds for chemotherapy benefit, while raising important questions about whether younger patients with intermediate scores benefit from chemotherapy itself or from the ovarian suppression it causes.

Panelists discuss how the RxPONDER trial data transformed breast cancer treatment by demonstrating that postmenopausal women with 1 to 3 positive lymph nodes and low recurrence scores could safely avoid chemotherapy, while highlighting the controversy about chemotherapy benefit in premenopausal patients where clinical judgment and nuanced assessment of menopausal status remain crucial.

Panelists discuss how the RSClin tool provides more personalized information by combining recurrence scores with clinicopathological data, offering patients specific predictions about their prognosis and potential chemotherapy benefit rather than general outcomes for patients with similar scores.

Panelists discuss how clinical factors such as nodal status influence genomic testing decisions, referencing the TAILORx and RxPONDER trials whose data demonstrated that chemotherapy benefit varies based on recurrence score and menopausal status, highlighting the need for nuanced shared decision-making rather than strict cutoffs.

Panelists discuss how they primarily use the 21-gene assay (Oncotype DX) for estrogen receptor–positive (ER+), HER2-negative (HER2–) breast cancers with minimal nodal disease due to its robust data from multiple trials, whereas other assays such as the Breast Cancer Index (BCI) are better for evaluating extended endocrine therapy benefits.

Panelists discuss how community practitioners face challenges with genomic testing due to working across multiple hospitals with different medical oncology groups who may have varying preferences for assays, emphasizing the importance of communication, established algorithms, and leveraging partnerships with testing companies.

Discover essential insights on breast cancer awareness, prevention, and treatment options to empower your health journey.

Discover essential insights on breast cancer awareness, prevention, and treatment options to empower your health journey.

The panel looks to the future landscape for HER2+ breast cancer, highlighting emerging treatment practices and currently unmet needs.

Focusing on the selection of subsequent therapies for patients with HER2-low/HER2+ metastatic breast cancer, the panel discusses treatment sequencing considerations and practices.

Breast cancer specialists discuss adverse events associated with T-DXd, focusing on monitoring for interstitial lung disease (ILD) and the role of re-challenging patients with T-DXd after resolution of grade 1 ILD.

Aditya Bardia, MD, MPH, shares comprehensive insights on the DESTINY-Breast06 study evaluating T-DXd in HER2-low and HER2 ultra-low metastatic breast cancer, and the panel offers its initial impressions.

Ian Krop, MD, PhD, provides an overview of HER2-low and HER2 ultra-low breast cancer and discusses challenges encountered during diagnosis.

Experts on breast cancer discuss the potential impact of ongoing research in HER2+ breast cancer, highlighting how results from the DESTINY-Breast07 study may translate to DESTINY-Breast09.

Melinda Telli, MD, provides an overview of ongoing research in HER2+ metastatic breast cancer, highlighting the DESTINY-Breast09, PATINA, INAVO122, and HER2CLIMB-05 studies.

The panel provides comprehensive insights on approaching first-line treatment of patients with HER2+ metastatic breast cancer and the role of neratinib.

Breast cancer specialists outline their institution’s practices regarding the choice between subcutaneous fixed-dose pertuzumab – trastuzumab-hyaluronidase and intravenous pertuzumab and trastuzumab.

Kandace P. McGuire, MD, provides clinical insights on how patient monitoring practices inform discussions around surgical options, providing the potential for deescalating surgical management.

Ian Krop, MD, PhD, outlines his institution’s approach to utilizing neoadjuvant therapy in patients with HER2+ early breast cancer, and Melinda Telli, MD, discusses the role of surgery.

A panel of experts on breast cancer provide insights on challenges encountered during the diagnosis of HER2+ early breast cancer and discuss the role of immunohistochemistry and FISH testing.

Kandace McGuire, MD, associate professor of Surgery, UNC Department of Surgery, Division of Surgical Oncology, UNC School of Medicine, discusses refinements needed in surgery for the treatment of patients with metastatic breast cancer during the 2016 OncLive State of the Science Summit on Metastatic Breast Cancer.

Kandace McGuire, MD, associate professor of Surgery, UNC Department of Surgery, Division of Surgical Oncology, UNC School of Medicine, discusses the evolving role of surgery in the treatment of patients with metastatic breast cancer.