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HER2+ Breast Cancer Paradigm Evolving With Practice-Changing New Options

Brandon Scalea
Published: Tuesday, Apr 09, 2019

Mark D. Pegram, MD
Mark D. Pegram, MD
Breast cancer treatment has evolved dramatically over the past 2 decades, said Mark D. Pegram, MD, and several approaches are emerging for those with HER2-positive metastatic disease in the form of new antibody-drug conjugates (ADCs) and small molecule inhibitors.

, Pegram highlighted data from pivotal studies that have helped to shape the current landscape of HER2-positive breast cancer and shed light on emerging agents that are showing promise in the pipeline.

OncLive: What have been the most exciting data in the HER2-positive breast cancer space?

Pegram: There has never been a more exciting time to be in the area of clinical research and clinical investigation for HER2-positive breast cancer. Some might say that there is not much work left to be done, particularly in early stages of HER2-positive breast cancer, because of the results of the adjuvant trastuzumab plus chemotherapy trials. These studies, from over a decade ago, were so spectacular that some people feel the “heavy lifting” is over.

The adjuvant T-DM1 data are essentially the same numbers, albeit in a different patient population. Nevertheless, those numbers are impressive and, indeed, practice-changing. Therefore, these are some of the things that are exciting, but there is more work left to be done and a lot of ongoing work is exploring promising therapies for the metastatic setting, which will translate to early-stage disease at a later date.

How will the results of the KATHERINE study shift focus in the adjuvant setting?

First, the stunning results from the KATHERINE trial will change practice. Secondly, those data will also change the way that we use HER2-targeted agents. To date, we had the option of adding a second HER2-directed antibody for high-risk patients. However, now we have an actual biological read using pCR in the adjuvant setting.


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