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HER2+ Breast Cancer Outlook Improved, But More Work Remains

Gina Columbus
Published: Friday, May 04, 2018

Kelly McCann, MD, PhD

Kelly McCann, MD, PhD
The outlook of HER2-positive breast cancer has vastly improved in recent years, in large part due to the emergence of targeted therapies that have had a significant impact on patient outcomes, says Kelly McCann, MD, PhD.

on Breast Cancer, McCann discussed the therapies available for patients with HER2-positive breast cancer and the potential benefit with additional subtyping in the field.

OncLive: Please provide an overview of your lecture on HER2-positive breast cancer in the curative setting.

McCann: The way the field is currently divided is that there are 3 major types of breast cancers: hormone receptor (HR)-positive/HER2-negative, HER2-positive, and triple-negative disease. Although, that is going to be subdivided later on. A large part of the success in the HER2-positive breast cancer field has been developing targeted therapies to the HER2 receptor. These included trastuzumab, pertuzumab, as well as 2 tyrosine kinase inhibitors (TKIs), which act intercellularly, called neratinib and lapatinib. 

Are there subtypes within HER2 that could predict better response to therapy?

We subdivide HR-positive/HER2-positive cancers out from the HR-negative breast cancers. We see that these are actually very different biologies and, in many trials, this has been recognized. We are starting to realize that the HR-positive/HER2-positive cancers—even though they don’t have a high rate of pathologic complete response (pCR), they still do have better overall outcomes than the HR-negative/HER2-positive breast cancer subtype. Eventually, they will be treated as different diseases in more ways than just adding endocrine therapy [to one over the other]. 

In terms of therapies, are there standard sequencing strategies? How are these agents typically tolerated?

A lot of work in the HER2-positive breast cancer field has been done in the neoadjuvant setting in looking at pCR rates as a measure of outcomes. 
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