Dr. Rugo on Unmet Needs Beyond Second-Line Treatment in HER2+ Breast Cancer

Hope S. Rugo, MD, director, Breast Oncology and Clinical Trials Education, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, discusses unmet needs beyond second-line treatment in HER2-positive breast cancer.

For patients with HER2-positive breast cancer, there are many effective treatment strategies, Rugo says. At the 2019 ASCO Annual Meeting, researchers presented updated data from the phase III CLEOPATRA study. The data further cemented the improvement in survival seen with the addition of pertuzumab (Perjeta) to trastuzumab (Herceptin) and taxane-based chemotherapy as frontline therapy in patients without prior exposure to trastuzumab. In the second-line setting, 2 studies have established standard approaches.

Beyond the second-line setting, there is no clear standard of care, Rugo says. Patients can continue to receive trastuzumab, they can receive lapatinib (Tykerb) with capecitabine, or they can be treated with other TKIs in development. Rugo concludes that the biggest unmet need in the third-line setting is that there are many potential options, but no clear path.