HER2+ Breast Cancer

Advancements in treatment options across the spectrum on women’s cancers include de-escalating therapy in HER2-positive breast cancer, using tisotumab vedotin-tftv in cervical cancer, shifting therapies to the frontline setting in endometrial cancer, and using checkpoint inhibitors in ovarian cancer.

The addition of nivolumab to trastuzumab deruxtecan did not result in a marked clinical benefit in patients with locally advanced unresectable or metastatic HER2-positive breast cancer.

HER2 expression appeared to be a significant predictor for response to fam-trastuzumab deruxtecan-nxki, according to findings from a biomarker analysis of patients with metastatic breast cancer in the phase 2 DAISY trial.

Nearly all patients with HER2-positive breast cancer with brain metastases who received fam-trastuzumab deruxtecan-nxki elicited benefit, according to data from a primary outcome analysis of the phase 2 TUXEDO-1 trial.

Overall health status and quality of life were maintained among patients with HER2-positive metastatic breast cancer who were treated with fam-trastuzumab deruxtecan-nxki compared with those who received ado-trastuzumab emtansine.

Neoadjuvant therapy generated similar benefits to adjuvant therapy in patients with early-stage, HER2-positive breast cancer treated in China, suggesting that neoadjuvant therapy should be used in this patient population.

Marcela Mazo Canola, MD, discusses pivotal trials in early-stage and metastatic HER2-positive breast cancer, plus ongoing trials to watch.

The FDA has approved fam-trastuzumab deruxtecan-nxki for adult patients with unresectable or metastatic HER2-positive breast cancer who have previously received an anti–HER2-based regimen either in the metastatic setting, or in the neoadjuvant or adjuvant setting, and have developed disease recurrence during or within 6 months of therapy completion.

Elias Obeid, MD, MPH, discusses the phase 3 KATHERINE trial in HER2-positive breast cancer.

Heather McArthur, MD, MPH, discusses key treatment developments in early-stage and metastatic HER2-positive breast cancer and triple-negative breast cancer, plus ongoing research at UT Southwestern Harold C. Simmons Comprehensive Cancer Center.

Mridula George, MD, discusses the variety of innovative HER2-positive breast cancer treatment options that have recently been approved or are undergoing investigation in clinical trials to broaden the standards of care for patients in this subgroup.

Sara A. Hurvitz, MD, medical oncologist and medical director at the Jonsson Comprehensive Cancer Center Clinical Research Unit, discussed pivotal findings in the HER2-positive treatment landscape that possess the potential to change practice.

Sara A. Hurvitz, MD, discusses the clinical implications of the phase 3 DESTINY-Breast03 trial in HER2-positive breast cancer.

The integration of HER2-targeted therapies into the treatment paradigm for patients with early-stage breast cancer, specifically the standard trastuzumab, has shifted focus away from whether patients should receive to how and when they should receive treatment with these agents.

The treatment of patients with HER2-positive metastatic breast cancer can now be tailored based on the presence of active central nervous system disease, due to substantial advances made in the past few years into small molecule inhibitors and macromolecule biologics.

Clinicians with patients who are experiencing cardiotoxicity as a result of their breast cancer treatment should address the cardiotoxicity using a team-oriented approach based on guideline-directed therapies.

Sara M. Tolaney, MD, MPH, discusses the efficacy of trastuzumab deruxtecan in the second-line setting and its potential to move into the first-line treatment of HER2-positive breast cancer.

Dr Hurvitz sheds light on shifts in practice patterns in HER2-positive breast cancer in light of data that emerged in 2021, remaining questions regarding treatment sequencing, the importance of updates to the National Comprehensive Cancer Network guidelines in metastatic HER2-positive breast cancer, and future directions to keep an eye on in 2022.

An abundance of riches in the form of new data for HER2-targeted agents continues to drive progress for patients with metastatic breast cancer.

Patients with HER2-positive, early-stage breast cancer who achieved a pathologic complete response after receiving HER2-targeted therapy experienced better outcomes in terms of disease-free survival and overall survival vs those who did not, according to data from a real-world study.

Significant progress has been made toward the initiation of the phase 3 FLAMINGO-01 trial, which will evaluate the combination of the immunotherapy GP2 with granulocyte macrophage colony stimulating factor in the adjuvant treatment of HER2/neu- and HLA-A*02–positive patients following surgery and trastuzumab-based therapy.

Aditya Bardia, MD, MPH, discusses key updates in HER2-positive, hormone receptor–positive, and triple-negative breast cancers, as well as the evolving clinical application of gene signature assays, liquid biopsies, and genotyping.

The National Comprehensive Cancer Network guidelines were updated for 2022 regarding the treatment of patients with breast cancer to include 2 new recommendations involving neratinib.

John Cole, MD, discusses the next steps with tucatinib in HER2-positive breast cancer.

The Scottish Medicines Consortium has accepted fam-trastuzumab deruxtecan-nxki as a treatment option for adult patients with HER2-positive unresectable or metastatic breast cancer who have previously received 2 or more anti–HER2-based therapies.