Oncology Brothers: Practice-Changing Cancer Discussions How to Treat HER2+ Breast Cancer - Discussion with Dr. Sarah Sammons
Feb 17, 2025
Join Dr. Sarah Sammons, a medical oncologist at Dana-Farber Cancer Institute, as she discusses groundbreaking insights into HER2-positive breast cancer treatment. She explores treatment options for early-stage HER2-positive patients, including key findings from the APT trial. The conversation shifts to the latest data from the PATINA trial, revealing its implications for metastatic cases. Dr. Sammons also highlights innovations like T-DXd for brain metastases and the management of toxicities with neoadjuvant therapies. Tune in for practical pearls that could transform treatment decisions!
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Manage Tiny HER2+ Tumors Case-By-Case
- For T1a (<5 mm) HER2+ tumors, weigh age, ER status, multifocality, and patient preference before treating.
- Offer adjuvant paclitaxel plus trastuzumab for higher-risk small tumors, especially ER-negative or young patients.
Use Imaging To Guide Neoadjuvant Decisions
- For T1c tumors, get axillary ultrasound to rule out suspicious nodes before deciding neoadjuvant therapy.
- Consider neoadjuvant THP for tumors near 2 cm to assess pCR and guide escalation to T-DM1 or de-escalation.
Prefer TCHP For Locally Advanced HER2+
- Use neoadjuvant TCHP for stage II–III HER2+ disease to assess response and allow adjuvant escalation to T-DM1 when needed.
- Reserve anthracycline-containing regimens for special cases with tumor heterogeneity or HER2-negative nodal disease.