Dr. Traina Discusses Neratinib in HER2+ Breast Cancer

Tiffany A. Traina, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses neratinib (Nerlynx) in HER2-positive breast cancer.

In July 2017, the FDA approved neratinib for the extended adjuvant treatment of patients with early stage, HER2-positive breast cancer following postoperative trastuzumab (Herceptin). The approval followed a 12-4 recommendation from the Oncologic Drugs Advisory Committee, stemming from the results of the ExteNET trial.

Traina says that neratinib is in a unique position because so much has evolved in the treatment of patients with early stage HER2-positive disease in the past year. The use of pertuzumab (Perjeta) is more widespread with an approval for use in the neoadjuvant setting in combination with trastuzumab. Data from the APHINITY trial showed that 1 year of adjuvant trastuzumab and pertuzumab was associated with improved survival outcomes.

These data makes the integration of neratinib challenging, Traina explains. Early trials with neratinib did not include patients who had prior exposure to pertuzumab, making neratinib’s role in the sequencing of agents unclear.