Exploring Available Treatment Approaches for Patients With HER2-Positive Breast Cancer

William J. Gradishar, MD, chief of hematology and oncology, department of medicine, Betsy Bramsen Professorship of Breast Oncology, professor of medicine (hematology and oncology), Northwestern University's Feinberg School of Medicine, discusses the current standard of care for patients with HER2-positive breast cancer, as well as some other promising therapies in this space.

The current standard for frontline therapy in HER2-positive metastatic breast cancer remains a taxmen, either trastuzumab (Herceptin) or pertuzumab (Perjeta). T-DM1 is the standard for second-line therapy in this setting, and for the third-line, a number of therapies are available, such as the recently approved tucatinib (Tukysa).

T-DM1 remains where it is now, Gradishar says, but there is an effort to move the other drugs up. Clinical trials are comparing trastuzumab deruxtecan to T-DM1, while other studies are exploring tucatinib with T-DM1 versus T-DM1 alone. These are all predictable efforts to try to move a competitor drug up, either alone or in combination with T-DM1.