The Fellow on Call: The Heme/Onc Podcast Episode 066: Breast Cancer Series, Pt. 11-Metastatic HER2+ Breast Cancer
Jul 26, 2023
Dive into the complexities of metastatic HER2+ breast cancer. Explore the recurrence patterns associated with different subtypes and significant clinical case studies. Discover the evolution of first-line therapies, including crucial trial results supporting current standards of care. The discussion also highlights advanced treatments like TKIs and antibody-drug conjugates, alongside practical sequencing for later-line therapies. Gain insights into the promising future of treatment options as research continues to evolve.
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Different Relapse Timelines By Subtype
- HER2+ and triple-negative breast cancers relapse early, mostly within the first five years.
- Hormone-receptor positive cancers relapse slowly and can have late recurrences for many years.
Don’t Overuse Trial Median Survival
- Avoid quoting a single median overall survival from trials as a precise prognosis for patients.
- Use ranges and update prognosis as treatment response becomes clear in clinic.
Why Dual HER2 Blockade Works
- Trastuzumab and pertuzumab bind different HER2 sites and complement each other.
- Dual HER2 blockade with a taxane (THP) improved median OS by ~17 months in Cleopatra.