Dr. Ali on Choosing Neratinib in HER2+ Breast Cancer

Haythem Y. Ali, MD, senior medical oncologist, Henry Ford Hospital, discusses neratinib (Nerlynx) in the treatment of patients with HER2-positive breast cancer.

The ExteNET trial of neratinib in patients with early stage, HER2-positive breast cancer following postoperative trastuzumab (Herceptin) showed that the invasive disease-free survival rate at 2 years was 94.2% with neratinib versus 91.9% with placebo. This data, along with the findings of the phase II CONTROL trial, led to the FDA approval of the agent.

Ali says that the nice thing about this trial is that it was done in patients who had not received pertuzumab (Perjeta), and it showed a benefit in the estrogen receptor (ER)-positive group. If there is a patient who is ER-positive with high-risk disease, Ali says that neratinib escalation may be a good option. Until more information on the adjuvant setting is reported, Ali says this is his thought process when choosing treatment.