Dr. Chien on Treatment Duration in HER2+ Breast Cancer

A. Jo Chien, MD, associate clinical professor, Department of Medicine, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses treatment duration in HER2-positive breast cancer.

Optimal treatment duration for patients with early-stage HER2-positive breast cancer is a big area of discussion, says Chien. In the field, there are challenges in identifying which patients can get away with less treatment and those who remain at high-risk despite use of trastuzumab (Herceptin), adds Chien.

Despite trastuzumab, approximately 1/4 of patients will relapse and need subsequent therapy. There are a number of new agents that have entered the field, such as pertuzumab (Perjeta) and neratinib (Nerlyx) that can be used in the early-stage setting.

On the other hand, there are also patients who are being overtreated, notes Chien. Historical studies were done in patients with high-risk disease, including positive lymph nodes and larger tumors. Those with node-negative disease and smaller tumors may not need as intensive treatment, states Chien.