Videos

Practical considerations for the sequencing or combination of novel antibody drug conjugates to optimize outcomes for patients with HER2-low breast cancer. 

HER2-low Breast Cancer: Practical Applications of ADC Therapy 

Experts take a look at clinical data behind novel antibody drug conjugates and consider how they may impact the management of HER2-low breast cancer.

Treating HER2-low Breast Cancer With Novel Antibody Drug Conjugates 

Focused discussion on the methods used to identify a patient’s HER2 status and why it is important to investigate in patients with breast cancer. 

Strategies in Identifying and Stratifying HER2 Status in Breast Cancer

Shared insight on the current state of HER2 classification and testing and in breast cancer, with respect to how it may influence future treatment approaches.

Current Landscape of HER2 Testing in Breast Cancer

Zahi Mitri, MD, MS, assistant professor of medicine, Oregon Health and Science University (OHSU), discusses developments in the treatment of patients with HER2-positive breast cancer.

Currently, several effective novel therapies are available for patients with HER2-positive breast cancer, although it is common for there to be concern and unfamiliarity with how to best utilize these options, according to Mitri. The benefits observed with these drugs, especially the combinations of tucatinib (Tukysa) and fam-trastuzumab deruxtecan-nxki (Enhertu), significantly outweigh the potential adverse effects, Mitri notes.

The positive data reported with tucatinib and trastuzumab deruxtecan should be encouraging, and these regimens should not only be recommended to patients, but also included in earlier lines of therapy because of their substantial benefit over chemotherapy plus trastuzumab (Herceptin), or other available regimens, Mitri concludes.

Zahi Mitri, MD, MS, discusses developments in the treatment of patients with HER2-positive breast cancer.

Dr. Mitri on Developments in HER2+ Breast Cancer 

Zahi Mitri, MD, MS, assistant professor of medicine, Oregon Health and Science University (OHSU), discusses the treatment landscape of HER2-positive breast cancer.

The presentation of the NSABP B-47 trial at the 2017 San Antonio Breast Cancer Symposium confirmed that patients who have HER2 amplification are those who benefit from HER2-directed therapy, says Mitri.

The duration of adjuvant therapy for these patients is still 1 year of trastuzumab (Herceptin), says Mitri. The APHINITY trial added pertuzumab (Perjeta) to adjuvant therapy with trastuzumab. Additionally, the ExteNET trial led to the approval of neratinib (Nerlynx) for the extended adjuvant treatment of patients with early stage, HER2-positive breast cancer following postoperative trastuzumab.

In the management of metastatic disease, physicians can use pertuzumab, as well as ado-trastuzumab emtansine (T-DM1; Kadcyla). There are new agents in development that serve as exciting novel anti-HER2 therapies, explains Mitri.

At OSHU, physicians tend to use neoadjuvant therapy. Physicians still give chemotherapy with an anti-HER2 blockade in the neoadjuvant setting. Following surgery, physicians used to complete just 1 year of therapy with trastuzumab. Now, physicians are adding pertuzumab in patients who qualify for it. Neratinib may be considered for patients following 1 year of therapy.

Zahi Mitri, MD, MS, assistant professor of medicine, Oregon Health and Science University, discusses the treatment landscape of HER2-positive breast cancer.

Dr. Mitri on the Treatment Landscape of HER2+ Breast Cancer

Zahi Mitri, MD, MS, assistant professor of medicine, Oregon Health and Science University, discusses the use of neratinib (Nerlynx) and pertuzumab (Perjeta) in patients with HER2-amplified breast cancer.

In light of a recent subgroup analysis, there is a lot of talk whether physicians should use pertuzumab for ER-negative, HER2-amplified breast cancer and neratinib for ER-positive, HER2-amplified breast cancer, says Mitri. At this point, the primary endpoint in both studies was positive. If physicians want to do subgroup analyses, it seems that most of the benefit of neratinib is in the ER-positive subgroup.

For pertuzumab, the benefit is similar in both, but more so in the ER-negative subgroup. At this point, Mitri says he is sticking to the primary endpoint of the study. If physicians think that someone deserves pertuzumab upfront, they should offer neratinib subsequently. However, if someone has really bad tolerance to one or the other, then physicians have to address that. Though the overall survival was the same in the APHINITY study of pertuzumab and the ExteNET study of neratinib, the ER-negative subgroup did not seem to benefit, says Mitri.

Zahi Mitri, MD, MS

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