We have had a lot of approvals of new agents recently, which is a win. The challenge is how to sequence them and how to best use them. We have seen the approvals of T-DM1 and pertuzumab in the past couple of years and that adds to the standard medicine we had before trastuzumab. Pertuzumab is being used predominantly in the first-line metastatic setting and is also approved in the neoadjuvant setting, so before surgery and early disease. T-DM1 is also only approved right now for metastatic disease, but both of these drugs are being studied in the adjuvant setting in large clinical trials. The challenge over the next few years is really going to be where to sequence these drugs, where to place them, and how best to use them in combination.What are some of the most exciting advances in breast cancer on the horizon?
Immunotherapy is very exciting. There has already been buzz about immunotherapy in other tumor types such as lung cancer, melanoma, and kidney cancer. Based on last year’s data from the KEYNOTE-012 [pembrolizumab] study, it looks like triple-negative breast cancer responds to immunotherapy, as well. Therefore, there is now a push to look at immunotherapy more heavily in breast cancer, since it has been so successful in other disease types, and I think that is very encouraging.