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 sequencing therapy in HER2-positive breast cancer.

Findings from the phase 3 CLEOPATRA trial (NCT00567190) established the combination of pertuzumab (Perjeta), trastuzumab (Herceptin), and docetaxel as the preferred frontline standard of care for patients with metastatic HER2-positive disease. The regimen demonstrated an overall survival advantage compared with trastuzumab, docetaxel, and placebo.

In addition to evidence-based strategies, patient preference and their extent of disease should be considered when selecting treatment, Toppmeyer explains. Unlike the adjuvant and neoadjuvant settings where sequencing strategies are more established, several options may be considered for patients with metastatic HER2-positive disease, allowing treatment to be tailored to an individual’s needs, Toppmeyer says. 

Additionally, clinical trials should be considered as an option for eligible patients to further progress the field, Toppmeyer concludes.

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Deborah L. Toppmeyer, MD, discusses sequencing therapy in HER2-positive breast cancer.



Dr. Toppmeyer on Sequencing Therapy 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.

Deborah L. Toppmeyer, MD, discusses the utility of clinical trials evaluating de-escalated treatment approaches in HER2-positive breast cancer. 

Deborah L. Toppmeyer, MD

Articles

Dr. Toppmeyer on Sequencing Therapy in HER2+ Breast Cancer

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