Dr. Hurvitz on Unmet Needs in HER2+ Breast Cancer

Sara A. Hurvitz, MD, director of Breast Cancer Clinical Research Program and co-director of the Santa Monica University of California Los Angeles (UCLA) Outpatient Hematology/Oncology Practice; and an assistant professor of medicine in the Division of Hematology/Oncology of the David Geffen School of Medicine at UCLA, discusses unmet needs within the field of HER2-positive breast cancer.

Although outcomes for patients with breast cancer have improved in recent years, with disease-free survival increasing to a much higher rate, even for patients who are identified as having higher-risk HER2-positive early stage disease, unmet needs remain, says Hurvitz. Patients will sometimes have a tumor recur only in the central nervous system (CNS) because most of the therapies that are being used, with the exception of neratinib (Nerlynx), do not penetrate the blood–brain barrier. Therefore, a metastatic recurrence can be seen exclusively in the brain, sparing the rest of the body and extracranial systems, explains Hurvitz.

Ongoing studies are examining whether the incidence of metastatic recurrences in the brain can be reduced. Moreover, data from the phase 3 ExteNET study with neratinib, as well as neratinib in the metastatic setting, show that the agent successfully delays the time to a CNS metastatic recurrence, notes Hurvitz. Newer drugs, such as tucatinib (Tukysa)-based therapies, are being explored in the adjuvant setting to determine whether the incidence of CNS metastases can be reduced in this patient population. That is a huge area of unmet need right now, concludes Hurvitz.