Dr Williams on Remaining Unmet Needs in HER2+ Breast Cancer

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Nicole O Williams, MD, discusses unmet needs for patients with HER2-positive breast cancer and potential future research directions in the space.

Nicole O Williams, MD, physician, medical oncologist, Division of Medical Oncology, director, the BreastCARE Program, Cancer and Aging Resiliency Clinic, the Ohio State University (OSU) College of Medicine, the OSU Comprehensive Cancer Center (OSUCC)–James, discusses unmet needs for patients with HER2-positive breast cancer and potential future research directions in the space.

Two main areas of interest highlight unmet needs in the HER2-positive breast cancer paradigm, Williams begins. The first is further clarification on the sequencing of therapies following disease progression on or after treatment with fam-trastuzumab deruxtecan-nxki (Enhertu), Williams explains. Additionally, the treatment of patients with HER2-positive breast cancer and brain metastases remains another area of need, she says. 

Williams notes that nearly 50% of patients with HER2-positive metastatic breast cancer will develop brain metastases, emphasizing the continued importance identifying therapies that penetrate the blood-brain barrier. If additional systemic therapies capable of penetrating the blood-brain barrier are identified, it could present the opportunity to systemically treat patients and reserve radiation for later lines of treatment, Williams says. Currently, both whole-brain and stereotactic radiation are standard first-line therapies for the treatment of patients with brain metastases, she continues. However, this approach is associated with adverse effects, mainly related to memory and cognitive decline, Williams notes.

Overall, treatment advances across the HER2-positive breast cancer spectrum have improved care for this patient population, Williams emphasizes. Several agents have been approved in recent years, aiding in the improvement of survival outcomes within the space. Despite these improvements, research is ongoing to address other unmet needs, with the goal of continuing to improve outcomes, Williams concludes.

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