Integrating Endocrine Therapy and Maintenance Concepts in HER2 Positive Metastatic Breast Cancer

This segment explores how hormone receptor positivity influences long-term treatment planning in HER2 positive metastatic breast cancer following initial response to HER2 directed therapy. The panel discusses whether and when to integrate endocrine therapy, referencing data from trials such as PATINA to illustrate maintenance strategies after induction therapy. Differences between continuous treatment designs, such as DESTINY-Breast09, and induction-maintenance approaches are examined, highlighting current evidence gaps. The discussion emphasizes that while endocrine therapy remains important, optimal sequencing with ADC-based regimens is not yet defined. Clinicians weigh response depth, tolerability, and patient preferences when considering de-escalation or maintenance strategies, acknowledging that ongoing and future trials will be needed to clarify best practices.