Dr. Pegram on Unmet Clinical Needs in HER2+ Metastatic Breast Cancer

Mark D. Pegram, MD, Suzy Yuan-Huey Hung Endowed Professor of Medical Oncology, associate dean for clinical research quality, Stanford University School of Medicine, associate director of clinical research, Stanford Comprehensive Cancer Institute, medical director, Stanford Clinical Translational Research Unit, Stanford Medicine, discusses unmet clinical needs in HER2-positive metastatic breast cancer.

HER2-positive metastatic breast cancer is largely incurable, representing a significant unmet need, Pegram says. Approximately half of this patient population will develop breast cancer brain metastases, creating a need for dedicated studies of HER2-targeted agents in this patient population, Pegram adds. Although there are robust data for tucatinib (Tukysa) in this population from the phase 2 HER2CLIMB trial (NCT02614794), the same level of evidence is lacking with other HER2-targeted agents in this patient population, Pegram says.

Notably, combining other drug classes with HER2-directed therapies may have a favorable effect on outcomes, Pegram adds. Ongoing trials, such as the PETINA trial (NCT02947685), are evaluating CDK4/6 inhibitors plus HER2-targeted therapy, Pegram explains. Moreover, the preclinical and early clinical data with the combination of these 2 therapeutic classes look promising and may extend the reach of CDK4/6 inhibitors from the estrogen receptor–positive setting to the HER2-positing setting, Pegram concludes.