Dr Tolaney on the Potential Role for Biomarkers in Early-Stage HER2+ Breast Cancer

Sara M. Tolaney, MD, MPH, chief, Division of Breast Oncology, Susan F. Smith Center for Women's Cancers, associate director, Susan F. Smith Center for Women's Cancers, senior physician, Dana-Farber Cancer Institute, associate professor of Medicine, Harvard Medical School, discusses the potential role for biomarkers in guiding treatment decisions for patients with early-stage HER2-positive breast cancer.

In the early-stage setting of HER2-positive breast cancer, current treatment capabilities offer patients optimal chances at achieving a cure, Tolaney begins, noting the current role of chemotherapy and HER2-targeted agents. However, she explains that challenges still remain for the subset of patients who will experience disease recurrence.

Identifying the biomarkers that could predict which patients are at higher risk for recurrence is crucial, according to Tolaney. She underscores the need for further research to delineate the role of these predictive biomarkers, which could enable clinicians to tailor treatment more effectively in the early-stage and up-front settings, she says.

During a presentation on the treatment of early-stage HER2-positive breast cancer given at the 23rd Annual International Congress on the Future of Breast Cancer® East, Tolaney underscored how factors such as pathologic complete response to neoadjuvant therapy and other biomarkers could help inform treatment strategies for this patient population.

Tolaney also addresses the potential for improving treatment adaptation beyond traditional response assessments to preoperative therapy. She suggests that integrating more novel monitoring methods, such as circulating tumor DNA (ctDNA), could be beneficial. Combining ctDNA with advanced imaging techniques, such as MRI or PET scans, early in the preoperative setting may provide more precise information to guide treatment-decision-making, she says.

Although significant progress has been made in the treatment of patients with early-stage HER2-positive breast cancer, continued research and development of biomarkers could further improve patient outcomes and lower the rate of patients who ultimately experience disease recurrence, Tolaney concludes.