Advances in the Treatment of Metastatic HER2-Positive Breast Cancer

Clinical Pearls

Sunil Verma, MD, MSEd, FRCPC, associate professor, University of Toronto, chair, Breast Medical Oncology, Sunnybrook Odette Cancer Centre, discusses advances in the treatment of patients with metastatic HER2-positive breast cancer.

• In 1998, OS in this population was 20 months with chemotherapy alone versus 25 months with chemotherapy plus trastuzumab
• The CLEOPATRA study suggested that with pertuzumab, trastuzumab, chemotherapy, and other lines of anti-HER2 therapy, survival exceeds 45 months, though many patients did not receiveT-DM1
• Now, with first-line pertuzumab, second-line T-DM1, and third-/fourth-line subsequent anti-HER2 therapy, OS exceeds 5 years
• Challenges remain regarding the treatment of patients at risk of brain metastases