Dr. Toppmeyer on the Utility of De-Escalation Trials in HER2+ Breast Cancer

Deborah L. Toppmeyer, MD, Chief Medical Officer and Director of the Stacy Goldstein Breast Cancer Center at Rutgers Cancer Institute of New Jersey, professor of medicine at Robert Wood Johnson Medical School, attending, Robert Wood Johnson University Hospital, discusses the utility of clinical trials evaluating de-escalated treatment approaches in HER2-positive breast cancer.

HER2-positive breast cancer patients respond well to HER2-directed therapies and chemotherapies, Toppmeyer explains. This brought about the question of whether it is possible to de-escalate therapy for patients. Moreover, findings from the phase 2 APT trial (NCT00542451) demonstrated an outstanding 7-year disease-free survival rate with adjuvant paclitaxel and trastuzumab (Herceptin), Toppmeyer expands.

These data led to the design of the ongoing phase 2 CompassHER2-pCR trial (NCT04266249), which is looking at dual targeted therapies utilizing trastuzumab and pertuzumab (Perjeta) with single-agent paclitaxel or docetaxel in patients with higher-risk disease, Toppmeyer continues. The study will be critically important because the data will inform whether patients can receive de-escalated chemotherapy, Toppmeyer concludes.