Dr. Carey on Ongoing Progress in HER2+ Breast Cancer

Lisa Carey, MD, associate director, Clinical Research, UNC Lineberger Comprehensive Cancer Center, Richardson and Marilyn Jacobs Preyer Distinguished Professorship for Breast Cancer Research, UNC-Chapel Hill, discusses the ongoing progress with agents in development for the potential treatment of patients with HER2-positive breast cancer.

The paradigm for HER2-positive breast cancer has been an incredible trajectory over the last few years, Carey explains. Some of the more exciting agents that are in development, she adds, are the small molecule inhibitors, such as neratinib. Some of these drugs may be easier to combine with monoclonal-based therapy, or they may be better than them alone. However, combinations may be much more effective, she says. Future treatment approaches will look to understand who needs combinations versus monotherapy.

One of the problems with HER2-directed therapies is their cost, Carey explains. However, some patients may do well with the biologically equivalent agent of trastuzumab (Herceptin). On the other hand, there are other patients who need dual therapy with multiple HER2-targeted drugs.

Previously, it may have been thought that pharmaceutical companies and drug developers would not spend time investigating in the area of HER2-positive breast cancer but, Carey explains, HER2 is an attractable target. Also, it is likely that, in the future, biomarkers will evolve past HER2 and incorporate other targets.