Adjuvant Strategies in HER2+ Brest Cancer: Timing and Tailoring

This is a video synopsis/summary of a Peer Exchange involving Joyce O’Shaughnessy, MD; Priyanka Sharma, MD; Claudine Isaacs, MD; Heather McArthur, MD; and Hope S. Rugo, MD, FASCO.

O’Shaughnessy shifts the discussion to the adjuvant setting, prompting insights from Sharma on managing patients undergoing preoperative therapy. They explore the timing of surgeries and potential variations based on patient responses. Sharma emphasizes setting patient expectations for the entire regimen, often opting for imaging after 3 or 4 cycles to assess cancer response. The conversation touches on the role of reimaging and considerations for changing treatments based on imaging results, with a focus on MRI and PET scans.

Sharma discusses ongoing trials such as DIRECT, investigating PET scan results to guide preoperative therapy. Challenges related to obtaining PET coverage, especially for Medicaid patients, are acknowledged. The importance of tailoring therapy based on pathological response is highlighted, with specific considerations for T-DM1 (trastuzumab emtansine) post pathologic complete response. Sharma delves into biomarkers such as HER2 and immune signatures, indicating their potential in prognostic assessments.

Video synopsis is AI-generated and reviewed by OncLive^® editorial staff.