Metastatic HER2+ Breast Cancer

Breast cancer experts review recently approved treatment options for relapsed or refractory HER2+ MBC, their intracranial efficacy, and sequencing of therapies.

Data from the following clinical trials are discussed:

• Tucatinib, trastuzumab, and capecitabine for HER2-positive metastatic breast cancer: HER2CLIMB. (Murthy RK et al. N Engl J Med. 2020;382:597-609.)

• Trastuzumab deruxtecan in previously treated HER2-positive breast cancer: DESTINY-Breast01. (Modi S et al. N Engl J Med. 2020;382:610-621.)

• Neratinib plus capecitabine versus lapatinib plus capecitabine in HER2+ metastatic breast cancer previously treated with ≥ 2 HER2-directed regimens: phase III NALA trial. (Saura C et al. J Clin Oncol. 2020;38(27):3138-3149.)

• Tucatinib versus placebo added to trastuzumab and capecitabine for patients with previously treated HER2+ metastatic breast cancer with brain metastases: HER2CLIMB. (Lin NU et al. 2020 ASCO annual meeting. Abstract 1005.)

• CNS metastases in HER2-positive metastatic breast cancer treated with trastuzumab deruxtecan: DESTINY-Breast01 subgroup analyses. (Jerusalem G et al. 2020 ESMO Breast Cancer annual meeting. Abstract 138O.)

• Impact of neratinib on development and progression of central nervous system metastases in patients with HER2-positive metastatic breast cancer: Findings from the NALA, NEfERT-T, and TBCRC 022 trials. (Awada A et al. 2019 SABCS. Poster P2-20-01.)

• Trastuzumab deruxtecan vs investigator's choice for HER2-low breast cancer that has spread or cannot be surgically removed: DESTINY-Breast04. (NCT03734029. Updated October 6, 2020. https://clinicaltrials.gov/ct2/show/NCT03734029)