Recent Trial Data in HER2+ Metastatic Breast Cancer

EP: 1.HER2+ Breast Cancer: Overview of the Treatment Armamentarium

EP: 2.Selecting and Sequencing Therapy for HER2+ Breast Cancer

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EP: 3.Recent Trial Data in HER2+ Metastatic Breast Cancer

EP: 4.Patient Profile 1: Frontline Therapy for HER2+ mBC

EP: 5.Patient Profile 1: Second-Line Therapy for HER2+ mBC

EP: 6.Patient Profile 1: Sequencing Therapies in HER2+ mBC

EP: 7.Patient Profile 2: Patient with Triple-Positive mBC

EP: 8.Patient Profile 2: Second-Line Therapy for Triple-Positive mBC

EP: 9.Patient Profile 2: 3L Therapy for Triple-Positive mBC

EP: 10.Considering Novel Therapy for HER2+ Metastatic Breast Cancer

EP: 11.Patient Profile 1: 62-Year-Old Woman With Metastatic Breast Cancer

EP: 12.Patient Profile 1: Trastuzumab Deruxtecan for HER2+ Metastatic BC

EP: 13.Patient Profile 2: 26-Year-Old Woman With Triple Positive Breast Cancer

EP: 14.Patient Profile 2: Strategies for Managing Brain Metastases in HER2+ Metastatic Breast Cancer

EP: 15.Patient Profile 2: How Should T-DM1 Be Sequenced in HER2+ mBC?

EP: 16.Patient Profile 2: Clinical Utility of the HER2CLIMB Regimen for HER2+ mBC

EP: 17.Patient Profile 2: Treatment Sequencing in a Patient with Progressive Brain Metastases

EP: 18.Patient Profile 3: 43-Year-Old Woman With Metastatic Breast Cancer Progressing Through Multiple Lines of Therapy

EP: 19.Patient Profile 3: Treatment Sequencing in a Patient with metastatic HER2+ Breast Cancer

EP: 20.Patient Profile 4: Strategies for Managing ILD in Patients Receiving Trastuzumab Deruxtecan

EP: 21.Patient Profile 4: Managing AEs in Patients Receiving Treatment for HER2+ BC

EP: 22.Patient Profile 5: Strategies for Managing Elevated Liver Function Tests in Patients on the HER2CLIMB Regimen

EP: 23.Future Directions in the Management of HER2+ Breast Cancer

Transcript:

Neil Iyengar, MD:Before we get to the cases, I want to briefly touch on some of the recent data that came out of the San Antonio [Breast Cancer Symposium] this past December. I will mention that I was particularly struck by long-term data from the HER2CLIMB trial. We also saw some subgroup analysis from the DESTINY-Breast03 study. I’ll point out that in the longer-term follow-up of HER2CLIMB that was presented at San Antonio, we continue to see the overall survival benefit and we continue to see prolonged overall survival benefits. So we certainly know that tucatinib is indeed an active agent.

In the DESTINY-Breast-03 subgroup analysis that we saw at San Antonio, we got a signal that trastuzumab-deruxtecan may also have CNS [central nervous system] activity in the patients within that trial who had stable brain metastasis. Now we have data from a large prospective randomized controlled trial, HER2CLIMB, showing the activity of tucatinib-based therapy in patients with stable and active brain metastases, as well as subgroup data from DESTINY-Breast-03 showing that trastuzumab-deruxtecan might have activity in patients with stable brain metastasis.

Of course, we also have data from the TUXEDO trial and the DEBRA study, both suggesting that trastuzumab-deruxtecan has activity in stable brain metastasis, and possibly in active brain metastasis as well, although, additional data are needed. As you mentioned, Milana, this is a major area of need for our patients with HER2-positive breast cancer. You mentioned that in HER2CLIMB, almost 50% of patients who had a baseline MRI had brain metastasis. This is higher than some of the prior observational cohort data, which suggested 30% to 40% of patients. I think that if we start screening our asymptomatic patients, we’ll find that the rates of CNS involvement are actually even higher.

Transcript edited for clarity.