Debu Tripathy, MD, discusses the use of tucatinib, capecitabine, and trastuzumab for the treatment of patients with HER2-positive breast cancer and leptomeningeal disease in other HER2-positive cancer types.
Debu Tripathy, MD, professor and chairman of the Department of Breast Medical Oncology, Division of Cancer Medicine, at The University of Texas MD Anderson Cancer Center, discusses the use of tucatinib (Tukysa), capecitabine (Xeloda), and trastuzumab (Herceptin) for the treatment of patients with HER2-positive breast cancer and leptomeningeal disease (LMD) in other HER2-positive cancer types.
According to Tripathy, HER2-positive mutations occur in other cancer types outside of breast cancer. For example, in gastric cancer there is a 20% to 25% HER-positivity rate. The amplification of HER2 can also be seen across a broad range of cancer types.
Even in patients with HER2-negative cancers, some patients develop mutations. This is especially true in those who are hormone receptor-positive who previously received endocrine therapy, he said. Even in patients who test negative for such mutations are at risk. These patients may not have HER2 levels high enough to test positive, they may still have mutations. Such mutations often respond to kinase inhibitors, with better results being seen if combined with endocrine therapy.
For patients with brain metastases, they may benefit from treatment that crosses the blood-brain barrier.