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.
Data presented from the INSEMA trial during the 2021 San Antonio Breast Cancer Symposium indicated that patients with early-stage breast cancer had better quality of life outcomes when forgoing a sentinel lymph node biopsy and axillary lymph node dissection. However, patients had improved arm symptoms and functioning with SLNB vs ALND.
Neratinib (Nerlynx) induced positive overall response rates in patients with heavily pretreated hormone receptor–positive/HER2-negative, HER2-mutant metastatic breast cancer when combined with fulvestrant and trastuzumab, and also in patients with metastatic HER2-mutant triple-negative breast cancer when combined with trastuzumab.
Certain adverse effects associated with olaparib were minimal and resolved with appropriate management in patients with germline BRCA1/2 mutations in patients with high-risk, HER2-negative, early-stage breast cancer.
Pathologic complete response and event-free survival was not found to be significantly affected by race among patients with high-risk breast cancer who received neoadjuvant chemotherapy; however, disparities were observed among patients who did not achieve a pCR.
Trastuzumab deruxtecan led to prolonged progression-free survival and higher responses vs trastuzumab emtansine as second-line therapy in patients with HER2-positive metastatic breast cancer across all patients subgroups, including those with and without baseline brain metastases.
Prior research has shown that the combination of trastuzumab deruxtecan plus pertuzumab may be superior to T-trastuzumab deruxtecan alone in patients with HER2-positive metastatic breast cancer and the combination is now under examination in the phase 3 DESTINY-Breast09 trial.
Adjuvant treatment with neratinib or ado-trastuzumab emtansine resulted in a greater reduction in the risk of disease recurrence compared with other therapies in an epidemiologic model of HER2-positive, early-stage breast cancer.
The addition of the bispecific antibody zanidatamab to single-agent chemotherapy was found to produce promising antitumor activity with acceptable tolerability in heavily pretreated patients with HER2-positive breast cancer.
Significant outcome differences were observed in premenopausal vs postmenopausal patients with hormone receptor–positive, HER2-negative breast cancer who had 1 to 3 positive lymph nodes and received adjuvant chemotherapy as well as endocrine therapy.
A non-chemotherapy–based targeted regimen comprised of tucatinib, palbociclib, and letrozole resulted in prolonged central nervous system progression-free survival in patients with hormone receptor–positive, HER2-positive breast cancer.
Aromatase inhibitors significantly reduced the risk of breast cancer recurrence in premenopausal women with estrogen receptor–positive breast cancer receiving ovarian suppression compared with tamoxifen.