Dr. Krop Discusses Progress Made in Metastatic HER2+ Breast Cancer

Ian E. Krop, MD, PhD, associate chief, Division of Breast Oncology, Susan F. Smith Center for Women’s Cancers, clinical research director, Breast Oncology Center, senior physician, Dana-Farber Cancer Institute, associate professor of medicine, Harvard Medical School, discusses progress made in 2021 in the management of HER2-positive breast cancer.

The field of metastatic HER2-positive breast cancer is moving toward providing patients with long-term disease control and, theoretically, cure with the use of HER2-directed agents, antibody-drug conjugates (ADCs), and TKIs like tucatinib (Tukysa), Krop says. Optimizing treatment sequencing with these agents has the potential to eradicate all clones of metastatic disease.

In the coming years, agents that proved highly efficacious in the metastatic setting may be found to have clinical utility in early-stage disease, Krop explains. For example, the ongoing phase 3 CompassHER2 RD Trial (NCT04457596) is evaluating tucatinib plus ado-trastuzumab emtansine (T-DM1; Kadcyla) vs T-DM1 alone to prevent relapses in patients with high-risk HER2-positive breast cancer. The ongoing phase 3 DESTINY-Breast05 trial (NCT04622319) is comparing fam-trastuzumab deruxtecan-nxki (Enhertu) with T-DM1 in high-risk patients with residual invasive disease following neoadjuvant therapy.

A goal of ongoing clinical trials is to find strategies to reduce the risk of patients with early-stage HER2-positive breast cancer developing metastatic disease, Krop concludes.