Dr. Ali on the Future of Adjuvant Care for HER2+ Breast Cancer

Haythem Y. Ali, MD, senior medical oncologist, Henry Ford Hospital, discusses the future of adjuvant treatment for patients with HER2-positive breast cancer.

Ali says that a strong adjuvant strategy that is currently being used is de-escalating to single chemotherapy with trastuzumab (Herceptin). Prior attempts to lengthen the time of trastuzumab has not been shown to be beneficial in the adjuvant setting.

Another new adjuvant strategy is T-DM1 (ado-trastuzumab emtansine; Kadcyla). Ali says that T-DM1 will likely be useful in patients who do not achieve a complete response in the neoadjuvant setting. Trials are currently ongoing with the agent.

In the metastatic setting, there are tyrosine kinase inhibitors that are more selective than neratinib (Nerlynx), with a more favorable toxicity profile, Ali says. If these agents are successful, they may be used in the adjuvant setting.