Dr. Hart on Personalized Treatment Approach for Patients With HER2+ Breast Cancer

Lowell L. Hart, MD, FACP, scientific director of clinical research at Florida Cancer Specialists & Research Institute, and associate professor of internal medicine at Wake Forest School of Medicine, discusses personalized treatment approaches for patients with HER2-positive breast cancer.

Patients with HER2-positive breast cancer should be re-biopsied at the time of their first recurrence, Hart explains. Drugs including fam-trastuzumab deruxtecan-nxki (Enhertu; DS-8201), trastuzumab (Herceptin), antibody-drug conjugates, and TKIs such as lapatinib (Tykerb), as well as investigational TKIs, such as tucatinib. have shown efficacy in this patient population. Tucatinib demonstrated promising activity at the 2019 San Antonio Breast Cancer Symposium.

However, there is still a challenge in treating patients with HER2-positive breast cancer who have brain metastases. While certain systemic therapies may not cross the blood—brain barrier, some of the newer agents in the pipeline, such as tucatinib, are able to better penetrate the brain, Hart concludes.