Treating HER2-Positive Beast Cancer in the Community Setting

In season 3, episode 8 of Targeted Talks, Christie J. Hilton, DO, a medical oncologist Allegheny Clinic Medical Oncology of Allegheny Health Network, discusses treating first- and second-line HER2-positive breast cancer.

The frontline combination of pertuzumab (Perjeta), trastuzumab (Herceptin), and chemotherapy is an FDA-approved treatment option for patients with HER2-positive early breast cancer who are at high risk of recurrence. According to Hilton, says that in her clinic, she uses a weekly docetaxel to decrease toxicity in her patients. Another approved frontline drug is tucatinib for adult patients with advanced unresectable or metastatic HER2-positive breast cancer, including patients with brain metastases, who have received 1 or more prior anti-HER2-based regimens in the metastatic setting.

In terms on second-line therapy, Hilton explains that the patient’s pace of disease, comorbidities, and other factors are important before selecting therapy. There are number of therapies available for these patients, including fam-trastuzumab deruxtecan (Enhertu), ado-trastuzumab emtansine (Kadcyla), and tucatinib. Clinical trials are abundant in this space, and this may change the standard-of-care in the future.

Overall, Hilton says much goes into making treatment decisions. Deciding which is the best treatment in each space will be determined by clinical trials. Hilton recommends enrolling patients into clinical trials so that they can receive the most innovative treatments