Dr. Sam on Sequencing Tucatinib and Trastuzumab Deruxtecan in HER2+ Breast Cancer

Christine Sam, MD, assistant member, Department of Individualized Cancer Management/Senior Adult Oncology Program, Moffitt Cancer Center, discusses strategies for sequencing tucatinib (Tukysa) and fam-trastuzumab deruxtecan-nxki (Enhertu) in the treatment of patients with HER2-positive breast cancer.

Tucatinib and trastuzumab deruxtecan have made a significant impact on the treatment of this population, but questions remain regarding which patients will derive the most benefit from these therapies and how they should be sequenced, according to Sam. Currently, sequencing for the drugs is determined by toxicity, as well as patient and tumor characteristics, Sam says. 

Although these agents are currently being utilized mostly in the third-line setting or later, a big question moving forward will be whether they can be moved earlier on in the course of treatment, Sam explains. To this end, several ongoing trials are examining whether this is feasible and whether it could further improve outcomes for patients, Sam concludes.