Sequencing Beyond First Line in HER2 Positive Metastatic Breast Cancer

This segment addresses the complex and evolving decisions surrounding treatment sequencing after progression on initial HER2 targeted therapy. The discussion explores how clinicians integrate prior response duration, pattern of progression, and patient specific factors when selecting subsequent lines of therapy. Panelists examine the evolving roles of antibody drug conjugates such as T DM1, CNS active tucatinib based regimens, and HER2 directed tyrosine kinase inhibitors as the therapeutic landscape continues to expand. Consideration is given to how emerging data may refine positioning of these options in 2025 and beyond. The conversation also highlights real world challenges that influence implementation, including infusion capacity, access to newer agents, and provider experience managing ADC associated toxicities. Differences between academic and community settings are discussed, emphasizing the importance of familiarity with safety monitoring and supportive care infrastructure. This segment underscores the need for individualized sequencing strategies that balance efficacy, tolerability, and practical feasibility across diverse clinical practice environments.