Optimizing Care in HER2+ Breast Cancer: Integrating Fertility Preservation and Advanced Treatment Approaches - Episode 4
Navigating Early-Line Treatment Options for HER2+ Metastatic Breast Cancer
Panelists discuss how the treatment landscape for early HER2-positive metastatic breast cancer has evolved, with taxane-pertuzumab-trastuzumab as first-line standard of care and T-DXd supplanting T-DM1 as the preferred second-line treatment.
Video content above is prompted by the following:
Early Treatment Options for HER2-Positive Metastatic Breast Cancer
Key Themes:
- First-line treatment
- Standard of care is taxane with pertuzumab-trastuzumab (based on CLEOPATRA study)
- Common practice to discontinue taxane after maximal response and maintain pertuzumab-trastuzumab until progression
- Second-line treatment
- DESTINY-Breast03 study showed T-DXd (trastuzumab deruxtecan) superior to T-DM1
- T-DXd showed nearly 4-times improvement in median progression-free survival (28 vs 7 months) over T-DM1
- Overall survival benefit was also demonstrated
- Third-line and beyond options
- Options include T-DM1, tucatinib-capecitabine-trastuzumab, chemotherapy plus trastuzumab, or chemotherapy plus margetuximab
- DESTINY-Breast07 data suggest benefit of adding pertuzumab to T-DXd, though not yet approved
Notable Insights:
Dr Vidal described: “Standard of care, which may change soon because we may have updated data coming up at ASCO but is for taxane pertuzumab-trastuzumab based on [the] CLEOPATRA study as the standard of care first-line treatment.”