Dr. Czerniecki on the Benefit of Tucatinib in HER2+ Breast Cancer and Brain Metastases

Brian Czerniecki, MD, PhD, chair and senior member of the Department of Breast Oncology at Moffitt Cancer Center, discusses the benefit of tucatinib (Tukysa) in patients with HER2-positive breast cancer and brain metastases.

On April 17, 2020, the FDA approved tucatinib in combination with trastuzumab (Herceptin) and capecitabine (Xeloda) for the treatment of patients with unresectable locally advanced or metastatic HER2-positive breast cancer, including those patients with brain metastases, following at least 1 prior anti–HER2­-based therapy in the metastatic setting.

The approval is based on findings from the phase 2 HER2CLIMB trial in which the triplet induced a 34% reduction in the risk of death compared with trastuzumab/capecitabine alone in the overall patient population and a 52% reduction in patients with brain metastases at baseline.

Although not all patients will benefit from tucatinib, the drug appears to reduce subclinical brain metastases, as well as prevent the development of symptomatic disease in the brain in some patients, says Czerniecki. Ultimately, the agent can have a significant impact on the treatment of about one-third of patients in this space, Czerniecki concludes.