Dr. Hurvitz on Novel Agents in HER2-Positive Breast Cancer

Sara A. Hurvitz, MD, director of the Breast Oncology Program, medical director of the Clinical Research Unit, University of California, Los Angeles Jonsson Comprehensive Cancer Center, discusses novel agents in HER2-positive breast cancer.

In August 2017, the FDA granted the investigational HER2-targeting antibody-drug conjugate DS-8201 a breakthrough therapy designation for the treatment of patients with HER2-positive, locally advanced, or metastatic breast cancer. Though the designation is indicated for HER2-positive patients, Hurvitz says it is also showing impressive efficacy in patients with HER2-low expressing breast cancer. Response rates of 50% have been observed in patients who have had a median of 7 prior lines of therapy. The agent also appears to have a tolerable toxicity profile.

Tucatinib is another agent that is showing impressive efficacy, especially in patients with brain metastases, notes Hurvitz. Based on phase I activity in central nervous systems of patients with HER2-positive tumors, it was granted orphan drug status by the FDA.

In the adjuvant setting, T-DM1 (ado-trastuzumab emtansine; Kadcyla) is being evaluated against paclitaxel and trastuzumab (Herceptin) for low-risk disease. If T-DM1 does better than paclitaxel and trastuzumab, it will offer women with low-risk stage I disease a regimen that does not result in hair loss, adds Hurvitz.