HER2+ Breast Cancer

The National Medical Products Administration of China has approved the use of single-agent fam-trastuzumab deruxtecan-nxki in adult patients with unresectable or metastatic HER2-positive breast cancer who previously received 1 or more anti–HER2-based regimens.

Jasmine Sukumar, MD, discusses the purpose of analyzing endocrine therapy use in HR-positive/HER2-positive patients, key data presented from the retrospective analysis at SABCS, and the need for improved understanding of clinical indications for endocrine therapy in this breast cancer subtype.

As targeted agents for various levels of HER2 expression have demonstrated dynamic interoperability and efficacy, the prognosis for HER2-positive disease has improved.

John Crown, MB, BCh, BAO, BSc, MD, MBA, discusses the rationale for evaluating lapatinib (Tykerb) with standard trastuzumab/chemotherapy regimen in patients with HER2-positive breast cancer, as well as contextualizes results from a phase 2 trial.

Nicholas P. McAndrew, MD, MSCE, discusses the need for HER2-targeted TKIs specifically designed to penetrate the blood-brain barrier, updated clinical data on the safety and tolerability of DZD1516 monotherapy, and the implications of nonclinical data on DZD1516 for treating CNS metastases in HER2-positive breast cancer.

Mridula George, MD, discusses the methods used to evaluate cardiotoxicity associated with adjuvant trastuzumab emtansine plus concurrent radiation therapy, and explains implications on the use of trastuzumab emtansine plus radiation in patients with early-stage HER2-positive breast cancer.

Fam-trastuzumab deruxtecan-nxki has received approval in the European Union as a single agent for the treatment of patients with unresectable or metastatic HER2-low breast cancer who have received prior chemotherapy for metastatic disease or developed disease recurrence during or within six months of completing adjuvant chemotherapy.

Frank A. Vicini, MD, discusses the potential utility of using the DCISionRT test to determine treatment benefit in the phase 3 NRG-NSABP-B43 trial in HER2-positive ductal carcinoma in situ of the breast.

Joyce A. O’Shaughnessy, MD, discusses key data from the phase 3 DESTINY-Breast02 and DESTINY-Breast03 trials in metastatic HER2-positive breast cancer.

Ajay Dhakal, MBBS, discusses the two key trials supporting the use of pertuzumab as a standard-of-care regimen in HER2-positive breast cancer.

John Crown, MB, BCh, BAO, BSc, MD, MBA, discusses previous research with anti-HER2 TKIs in HER2-positive breast cancer, expanded on key follow-up data from this phase 2 trial, and emphasized the importance of continued investigation into this underutilized combination.

Ajay Dhakal, MBBS, discusses the evolution and implementation of the antibody-drug conjugate trastuzumab deruxtecan across the landscape of HER2-positive breast cancer landscape.

Maryam Lustberg, MD, MPH, discusses key results from a retrospective analysis of ovarian suppression in HR–positive, HER2-positive breast cancer, the importance of assessing real-world practice patterns, and the need for continued study of other predictive biomarkers for endocrine therapy in this population.

Neoadjuvant and adjuvant pertuzumab plus trastuzumab with docetaxel continued to show improvements in event-free survival, disease-free survival and overall survival vs trastuzumab/docetaxel and placebo in Asian patients with HER2-positive early or locally advanced breast cancer.

Patient history and disease characteristics did not affect outcomes for patients with metastatic HER2-low breast cancer who received fam-trastuzumab deruxtecan-nxki in the DESTINY-Breast04 study.

Paolo Tarantino, MD, discusses the impact of the phase 3 DESTINY-Breast04 trial in the treatment of HER2-low breast cancer.

The United Kingdom’s National Institute for Health and Care Excellence has endorsed trastuzumab deruxtecan for use within the Cancer Drugs Fund for adult patients with HER2-positive, unresectable or metastatic breast cancer following at least 1 anti-HER2 treatment.

Neoadjuvant chemotherapy with dual HER2-blockade of pertuzumab and trastuzumab is well tolerated and increases the rate of pathological complete response in patients with HER2-positive breast cancer compared with regimens that contain trastuzumab only, while being neutral on drug cost.

Suchita Pakkala, MD, discusses ongoing efforts to integrate local therapy into HER2-positive breast cancer treatment.

DZD1516, a reversible and selective HER2 TKI with full blood–brain barrier penetration led to tumor responses, including in patients with baseline central nervous system metastases, in a phase 1 study of patients with metastatic HER2-positive breast cancer.

The safety profile for the combination of tucatinib, trastuzumab, and capecitabine from the phase 3 HER2CLIMB trial was confirmed with real-world data for patients with HER2-positive metastatic breast cancer.

Sara A. Hurvitz, MD, discusses updated survival data with fam-trastuzumab deruxtecan-nxki in HER2-positive, unresectable/metastatic breast cancer.

Patients with HER2-positive metastatic breast cancer experienced a significant survival benefit when treated with fam-trastuzumab deruxtecan compared with trastuzumab emtansine.

Trastuzumab deruxtecan demonstrated a 64% reduction in the risk of disease progression or death compared with physician's choice of treatment in patients with advanced HER2-positive unresectable and/or metastatic breast cancer who previously received ado-trastuzumab emtansine.

Ian Krop, MD, PhD, discusses findings from the phase 3 DESTINY-Breast02 trial in patients with HER2-positive metastatic breast cancer.