Video

Dr. Meisel on the Nuances of Utilizing Adjuvant T-DM1 in HER2+ Breast Cancer

Jane L. Meisel, MD, discusses some of the nuances of utilizing adjuvant ado-trastuzumab emtansine in HER2-positive breast cancer.

Jane L. Meisel, MD, associate professor, Departments of Hematology and Medical Oncology and Gynecology & Obstetrics, Winship Cancer Institute, Emory University School of Medicine, discusses some of the nuances of utilizing adjuvant ado-trastuzumab emtansine (T-DM1; Kadcyla) in HER2-positive breast cancer.

Findings from the phase 3 KATHERINE trial led to the FDA approval of adjuvant T-DM1 in patients with HER2-positive early breast cancer who have residual invasive disease following neoadjuvant trastuzumab (Herceptin) and chemotherapy. In the study, 18% of patients discontinued T-DM1 due to adverse effects (AEs), says Meisel.

Typically, patients enrolled on clinical trials are more fit and motivated to stay on treatment compared with real-world populations, says Meisel. As such, modifications with T-DM1 are likely needed because the results of the trial showed that T-DM1 is less tolerable vs trastuzumab alone, Meisel explains.

However, patients who are eligible to receive T-DM1 can derive a significant benefit from the therapy if tolerated, Meisel says. It is important to prepare patients of the potential toxicities associated with T-DM1 even when discussing neoadjuvant HER2-directed therapies, Meisel highlights. Patients who do not achieve a pathologic complete response to surgery should receive T-DM1 vs additional trastuzumab/pertuzumab, but it is important to monitor patients to ensure that toxicities, such as nosebleeds or gastrointestinal AEs, are managed early, concludes Meisel.

Related Videos
Dr Petrella on Selecting Frontline Therapy in Metastatic Melanoma
Omid Hamid, MD
Marlana M. Orloff, MD
Mark Faries, MD
6368672538112
Dr Jabbour on Bleximenib Monotherapy in KMT2A+ or NPM1+ R/R Acute Leukemia
Julie Lang, MD, discusses real-world outcomes of the neoadjuvant KEYNOTE-522 regimen in patients with early-stage triple-negative breast cancer.
Rene Y. McNall-Knapp, MD, pediatric hematologist-oncologist, Jimmy Everest Center, Oklahoma Children’s Hospital OU Health; professor, Department of Pediatrics, University of Oklahoma Health Sciences Center
John Andrew Livingston, MD, MS
Howard Colman, MD, PhD, Jan M. Huntsman Presidential Professor, Department of Neurosurgery, member, Brain Tumor Research Team, and leader, Center for Neurologic Cancers, Huntsman Cancer Institute, University of Utah