Opinion

Video

Key Clinical Trials in the First-Line Treatment of HER2+ Metastatic Breast Cancer

Oncologists discuss key learnings from clinical trials investigating the first-line treatment of patients with HER2-positive metastatic breast cancer, and how these findings help inform their clinical practice regarding selection of optimal systemic therapy regimens.

The discussion turns to several ongoing clinical trials in the first-line metastatic HER2+ breast cancer setting. Spring mentions the HER2CLiMB-05 study evaluating tucatinib or placebo added to trastuzumab/pertuzumab maintenance therapy after taxane induction, with a secondary endpoint of CNS progression-free survival given tucatinib's good brain penetration. Bhave notes they have this trial open at their site, highlighting tucatinib's tolerability and CNS penetration, with the goal of preventing brain metastases by using it upfront with trastuzumab/pertuzumab.

Bhave then brings up the DESTINY-Breast09 trial looking at adding the antibody-drug conjugate trastuzumab deruxtecan to taxane/trastuzumab/pertuzumab in the first-line setting, given the impressive activity seen with these agents.

They discuss the potential challenges of giving more intensive regimens like adding an ADC upfront when some patients can have very durable responses to standard taxane/trastuzumab/pertuzumab alone, especially those with de novo HER2+ disease versus more heterogeneous tumors.

Spring and Bhave talk about treatment duration with the taxane component before moving to trastuzumab/pertuzumab maintenance. Both typically follow the 6 cycles used in CLEOPATRA, though sometimes stop taxanes earlier if there is an excellent response but toxicity or extend a few more cycles in robust patients seeking greater response.

This summary was AI-generated and edited for clarity.

Related Videos
Sheldon M. Feldman, MD
2 KOLs are featured in this series.
2 KOLs are featured in this series.
2 KOLs are featured in this series.
2 KOLs are featured in this series.
In this episode of OncChats: Empowering Community Cancer Care, Dr. Rai emphasizes the importance of community outreach and support for patients with cancer, highlighting the need for holistic care that addresses both physiological and psychological aspects of treatment while reinforcing the value of strong relationships between primary care physicians and specialists.
In this episode of OncChats: Empowering Community Cancer Care, Dr. Woodworth sheds light on the “Road to Recovery” survivorship program at Henry Mayo, which supports cancer survivors by providing them with fitness, education, and mental health resources, and underscores the importance of mentorship programs for community providers to ensure equitable cancer care.
In this episode of OncChats: Empowering Community Cancer Care, Drs Woodworth and Rai, discuss their collaborative approach to cancer screening, emphasizing the importance of community efforts and individual assessments in integrating genetic testing and screenings into routine practice.