Dr. Gradishar on the Treatment Landscape in Metastatic HER2+ Breast Cancer

William J. Gradishar, MD, chief of hematology and oncology, Department of Medicine; Betsy Bramsen Professorship of Breast Oncology; and a professor of medicine (hematology and oncology) at Northwestern University Feinberg School of Medicine, discusses the ​current treatment landscape in metastatic HER2-positive breast cancer.

In the past year, a number of regulatory approvals ​have expanded the HER2-positive ​breast cancer armamentarium​, Gradishar says. Moreover, several other ​agents are poised to enter the space.

Two of the most recent approvals were of the antibody-drug conjugate fam-trastuzumab deruxtecan​-nxki (Enhertu) and ​the selective HER2-directed TKI tucatinib (Tukysa), the latter of which was evaluated in the ​phase 2 HER2CLIMB trial, says Gradishar.

Both agents have ​demonstrated significant clinical activity and unique strengths​, Gradishar explains. However, patients may experience some toxicities​ with either regimen.

Furthermore, ​neratinib (Nerlynx) was initially approved as an adjuvant therapy in HER2-positive breast cancer. However, after ​the results of the ​phase 3 NALA trial read out, the TKI received an indication in the metastatic setting​ after progression on at least 2 anti–HER2-based regimens, Gradishar concludes.