Dr. Cole on Next Steps With Tucatinib in HER2+ Breast Cancer

John Cole, MD, chairman, Community Oncology Practices, South Shore, Ochsner Medical Center, Ochsner Health, discusses the next steps with tucatinib (Tukysa) in HER2-positive breast cancer.

The phase 3 HER2CLIMB-02 trial (NCT03975647) is currently recruiting patients with advanced or metastatic HER2-positive breast cancer to evaluate the efficacy of ado-trastuzumab emtansine (T-DM1; Kadcyla) plus tucatinib vs T-DM1 alone. However, the results of this study may be difficult to integrate into clinical practice given the positive results of the phase 3 DESTINY-Breast03 trial (NCT03529110), which ​were presented during the 2021 San Antonio Breast Cancer Symposium. The findings demonstrated that fam-trastuzumab deruxtecan-nxki (Enhertu) elicited superior efficacy vs T-DM1 as second-line therapy for patients with HER2-positive metastatic breast cancer.

Knowledge of tucatinib remains limited as the agent is relatively new, so significant research is needed to determine whether tucatinib-based combinations will be more effective vs single-agent tucatinib, Cole explains. Moreover, it will be important to evaluate whether the combinations yield acceptable toxicities and efficacy that outweighs sequential therapy, Cole concludes.