Dr. Barrio on Treatment Options for HER2+ Breast Cancer

Andrea V. Barrio, MD, FACS, breast surgical oncologist, Memorial Sloan Kettering Cancer Center, discusses treatment options for patients with HER2-positive breast cancer.

HER2-positive disease is a subtype of breast cancer that represents about 20% of breast cancer cases, Barrio says. In 2006, adjuvant targeted therapy with trastuzumab (Herceptin) became widely used. More recently, dual HER2-targeted therapy with trastuzumab and pertuzumab (Perjeta) has shaped the landscape. The challenge remaining with this disease is determining which patients should undergo upfront surgery or neoadjuvant therapy. Barrio notes that this should depend on physician and patient goals, although it appears that surgery is becoming de-escalated in the paradigm in order to maintain patient quality of life.

For example, the goal of frontline chemotherapy for patients with node-positive disease is to make them node-negative, leading to less surgery. The biggest advantage of HER2-positive breast cancer is its high response rate to systemic therapy.