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Navigating the Changing Landscape in HER2-Positive Breast Cancer

Erin M. Burns, PhD, MSPH
Published: Monday, Mar 09, 2020

Sara A. Hurvitz, MD, an associate professor at the David Geffen School of Medicine and medical director of the Jonsson Comprehensive Cancer Center Clinical Research Unit at the University of California, Los Angeles

Sara A. Hurvitz, MD

The paradigm for treating patients with HER2-positive breast cancer is changing throughout the spectrum of the disease as a result of recent clinical trial findings regarding novel and established treatment regimens, according to Sara A. Hurvitz, MD. The focus on new strategies is needed because of the aggressive nature of the HER2- positive subtype; although trastuzumab (Herceptin) has substantially improved outcomes for this patient populations, approximately 25% of patients with earlystage disease will experience relapse within 10 years of a curative-intent, trastuzumab-based chemotherapy regimen.1 “For these reasons, multiple HER2-targeted therapies have been and are being developed to improve outcomes associated with this aggressive type of cancer,” Hurvitz, medical oncologist and medical director, Clinical Research Unit for the University of California, Los Angeles Jonsson Comprehensive Cancer Center, told OncLive®. “Understanding how and when to use each of these drugs is critical as we strive to optimize outcomes for our patients.”

Early-Stage Disease

There have been many data presented relating to neoadjuvant and adjuvant treatment for patients with HER2-positive breast cancer––including data for trastuzumab, pertuzumab (Perjeta), neratinib (Nerlynx), and ado-trastuzumab (T-DM1; Kadcyla)–– which have contributed to practice changes (Table 12-6). In an interview ahead of the 37th Annual Miami Breast Cancer Conference® (MBCC), Hurvitz previewed a few notable studies. “At the conference I will be reviewing practice-changing trial data from studies including KATHERINE, APHINITY, ExteNET, APT, and ATEMPT and will present a strategy for selection of optimal curative-intent neoadjuvant and/or adjuvant therapy for HER2-positive, early-stage disease,” Hurvitz explained.
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