Dr Mahtani on the Expansion of Targeted Therapies in HER2+ Breast Cancer

Reshma L. Mahtani, DO, medical oncologist, Miami Cancer Institute, chief, breast medical oncology, Baptist Health’s Wellness and Medical complex, discusses how the expansion of HER2-targeted agents has impacted the management of HER2-positive breast cancer care, and thereby improved patient outcomes.

Approximately 15% to 20% of breast cancers are classified as HER2-positive, representing a particularly aggressive subtype of the disease associated with an elevated risk of systemic and brain metastases, Mahtani begins. The introduction of trastuzumab (Herceptin) and subsequent HER2-directed therapies has markedly improved the prognosis for patients with this disease subtype, she states. Presently, there are 8 approved therapies targeting HER2, encompassing monoclonal antibodies, TKIs, and antibody-drug conjugates, Mahtani notes.

The expanded armamentarium of HER2-targeted therapies has revolutionized the management of HER2-positive breast cancer, providing patients with prolonged survival and increased treatment options, Mahtani emphasizes. However, the availability of these treatments also presents challenges, she says. Clinicians must remain vigilant regarding potential toxicities associated with HER2-targeted therapies and ensure appropriate monitoring of patients. Furthermore, dose adjustments may be necessary to mitigate adverse effects (AEs)and maintain patients' quality of life, Mahtani adds.

In managing HER2-positive breast cancer, research focus and endeavors now extend beyond extension of survival to encompassing the preservation of patients' overall well-being, Mahtani continues. It is imperative to prioritize strategies that optimize both clinical outcomes and quality of life. This entails a comprehensive approach that includes close monitoring, judicious use of therapies, and tailored interventions to address treatment-related AEs. Ultimately, by balancing the benefits and risks of HER2-targeted therapies, clinicians can optimize patient outcomes and enhance their overall treatment experience, Mahtani concludes.