HER2+ Breast Cancer

Fam-trastuzumab deruxtecan-nxki induced meaningful antitumor activity in patients with HER2-positive, HER2-low, or HER2-negative metastatic breast cancer who presented with brain metastases at baseline.

Suchita Pakkala, MD, discussed how treatments like tucatinib and fam-trastuzumab deruxtecan-nxki have widened the armamentarium for patients with brain metastases; the importance of enrolling these patients in clinical trials; and what future treatment sequencing might look like for this population.

Sara A. Hurvitz, MD, discusses the evolving treatment paradigm in HER2-positive breast cancer, ongoing research in the space, and developments in the treatment of triple-negative breast cancer.

Treatment decisions in the second-line setting for patients with HER2-positive metastatic breast cancer are not as cut-and-dried as deciding between which data have the best outcomes.

The combination of pegylated liposomal doxorubicin, cyclophosphamide, trastuzumab, and pertuzumab elicited encouraging responses with acceptable safety when given as neoadjuvant treatment in patients with HER2-positive breast cancer.

Jane Lowe Meisel, MD, discussed the emergence of HER2-low as a new category in breast cancer, outlining the significance of the phase 3 DESTINY-Breast04 trial and the unique qualities of trastuzumab deruxtecan in the HER2-positive and HER2-low populations.

DZD1516 monotherapy elicited early clinical activity and was found to be well tolerated in patients with HER2-positive metastatic breast cancer with or without brain metastases.

Suchita Pakkala, MD, discusses the importance for clinical trial enrollment for patients with breast cancer who have brain metastases.

Katherine Tkaczuk, MD, discusses the utilization of trastuzumab deruxtecan in HER2-positive breast cancer.

The addition of pyrotinib to trastuzumab and docetaxel significantly improved progression-free survival vs trastuzumab/docetaxel alone in patients with HER2-positive metastatic breast cancer.

Zanidatamab zovodotin was found to produce encouraging responses and to have a manageable toxicity profile when used as a monotherapy in heavily pretreated patients with HER2-positive solid cancers.

The addition of abemaciclib to trastuzumab, with or without fulvestrant, provided a numerical overall survival improvement over standard-of-care trastuzumab plus chemotherapy in patients with hormone receptor–positive, HER2-positive advanced breast cancer, according to data from the monarcHER trial.

A dramatic presentation at the 2022 American Society of Clinical Oncology Annual Meeting changed treatment standards seemingly overnight for women with previously treated metastatic HER2-low breast cancer. However, fundamental questions remain.

Shanu Modi, MD, discusses the significance of the approval of trastuzumab deruxtecan for patients with HER2-low breast cancer.

The United Kingdom Medicines and Healthcare Products Regulatory Agency has extended the conditional marketing authorization of fam-trastuzumab deruxtecan-nxki for single-agent use in adult patients in Great Britain who have HER2-positive unresectable or metastatic breast cancer and have received 1 or more prior HER2-based regimens.

Katherine Tkaczuk, MD, discusses practice-changing data across breast cancer subtypes that were discussed at the 2022 ASCO Annual Meeting, including data from DESTINY-Breast04 and the phase 3 PALOMA-2 trial, plus the utilization of CDK4/6 inhibitors and PARP inhibitors for select patients with breast cancer.

Erika P. Hamilton, MD, discusses testing used to identify patients with HER2-positive and HER2-low breast cancer.

The European Commission has approved fam-trastuzumab deruxtecan-nxki for use as a single agent in adult patients with unresectable or metastatic HER2-positive breast cancer who have previously received at least 1 anti–HER2-based regimen.

The European Medicines Agency has validated the marketing authorization application for trastuzumab duocarmazine for the treatment of patients with HER2-positive unresectable, locally advanced or metastatic breast cancer.

Neratinib-based combinations, antibody-drug conjugates, and bispecific antibodies represent novel and effective treatment options for patients with pretreated HER2-mutant and HER2-low metastatic breast cancer, but the successful integration of these regimens into care will require further investigation into current definitions of HER2 positivity.

Adrienne G. Waks, MD, highlights clinical trials that are studying emerging treatment escalation and de-escalation strategies in early stage HER2-positive breast cancer, elaborates on the future of immunotherapy in this setting, and explains the significance of establishing new biomarkers.

The addition of pertuzumab to standard adjuvant therapy of trastuzumab and chemotherapy continued to reduce the risk of disease recurrence or death for patients with HER2-positive early breast cancer according to data from the third interim overall survival analysis of the phase 3 APHINITY trial.

The FDA has accepted for review a biologics license application for vic-trastuzumab duocarmazine for the treatment of patients with HER2-positive unresectable locally advanced or metastatic breast cancer.

Vered Stearns, MD, FASCO, discusses how DESTINY-Breast04 has shifted the treatment paradigm for patients with HER2-low breast cancer, the exploration of treatment combinations being optimized in breast cancer, and the expansion of the treatment paradigm in triple-negative breast cancer.

Gregory Vidal, MD, PhD, discusses the impact of the phase 3 KATHERINE trial in HER2-positive breast cancer.