Navigating Early-Line Treatment Options for HER2+ Metastatic Breast Cancer

Video content above is prompted by the following:

Early Treatment Options for HER2-Positive Metastatic Breast Cancer

Key Themes:

• First-line treatment
• Standard of care is taxane with pertuzumab-trastuzumab (based on CLEOPATRA study)

• Common practice to discontinue taxane after maximal response and maintain pertuzumab-trastuzumab until progression
• Second-line treatment
• DESTINY-Breast03 study showed T-DXd (trastuzumab deruxtecan) superior to T-DM1

• T-DXd showed nearly 4-times improvement in median progression-free survival (28 vs 7 months) over T-DM1

• Overall survival benefit was also demonstrated
• Third-line and beyond options
• Options include T-DM1, tucatinib-capecitabine-trastuzumab, chemotherapy plus trastuzumab, or chemotherapy plus margetuximab

• DESTINY-Breast07 data suggest benefit of adding pertuzumab to T-DXd, though not yet approved

Notable Insights:

Dr Vidal described: “Standard of care, which may change soon because we may have updated data coming up at ASCO but is for taxane pertuzumab-trastuzumab based on [the] CLEOPATRA study as the standard of care first-line treatment.”