
Opinion|Videos|January 14, 2025
Current Practices for Targeted Therapies and Molecular Testing for HR+/HER2- Metastatic Breast Cancer
Panelists discuss how the latest NCCN guidelines for targeted therapies and biomarker testing in advanced/metastatic breast cancer highlight the importance of biomarker-driven approaches, with particular emphasis on the need for next-generation sequencing testing in the first-line setting, the implications of HER2-low classification, and how the recent FDA approval of a PI3K inhibitor may impact testing practices and treatment strategies.
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Episodes in this series

Video content above is prompted by the following:
- Please briefly mention the latest NCCN guidelines for targeted therapies and associated biomarker testing.
- How does biomarker testing differ in advanced/metastatic breast cancer from early-stage disease?
- What should be considered when testing in the first line for advanced disease?
- Is there a need for next-generation sequencing testing before first-line metastatic disease? (eg, BRCA, PIK3CA, PD-L1, NTRK, microsatellite instability–high/mismatch repair deficiency, high tumor mutational burden)
- Will the recent FDA approval of a PI3K inhibitor affect your testing practice?
- For a patient whose cancer has progressed, do you obtain a new biopsy or go back to the original sample? Why?
- How has immunohistochemistry (IHC) testing changed with the addition of HER2-low to NCCN guidelines?
- How are you interpreting IHC staining results for HER2-low?
- How are results reported? Are you given a percentage of staining, or are you given the category of HER2-low?
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Related to this article

Camizestrant plus a CDK4/6 inhibitor was approved in the European Union for ER-positive, HER2-negative advanced breast cancer with an emergent ESR1 mutation.

The FDA approved a bioequivalent formulation of olaparib for use in previously approved cancer indications.

The FDA approved gedatolisib in PIK3CA wild-type breast cancer, granted full approval to selpercatinib in RET fusion+ tumors, and more.

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The FDA approved gedatolisib/fulvestrant, with or without palbociclib, for hormone receptor–positive advanced breast cancer without a PIK3CA mutation.
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