Dr. Hurvitz on Therapeutics for HER2+ Metastatic Breast Cancer

Sara A. Hurvitz, MD, medical oncologist, medical director, Clinical Research Unit for University of California, Los Angeles Jonsson Comprehensive Cancer Center, discusses treatment options for patients with HER2-positive metastatic breast cancer.

HER2-positive breast cancer comprises 15% to 20% of all metastatic breast cancer but HER2-positive breast cancer is made of many different subtypes, explains Hurvitz. One of the most important features of HER2-positive breast cancer is whether the tumor has hormone co-expression, says Hurvitz. With a tumor that expresses both HER2 and hormone receptors, drugs that target the hormone and HER2 pathways can be used.

Additionally, studies are examining whether CDK4/6 inhibitors work well in this patient population, including the monarcHER study, which shows that adding abemaciclib (Verzenio) to trastuzumab (Herceptin) and fulvestrant improves outcomes for patients with metastatic hormone receptor—positive, HER2-positive breast cancer. In the future, patients with PIK3CA mutations will also be examined and research will continue to investigate whether adding drugs, such as alpelisib (Piqray), to HER2-targeted therapy will improve outcomes for patients with HER2-positive breast cancer, concludes Hurvitz.