Heather ​S. Han, MD, a research director and medical oncologist of Breast Oncology at Moffitt Cancer Center, discusses the benefit of adding pertuzumab (Perjeta) to trastuzumab (Herceptin) and chemotherapy in the phase 3 APHINITY trial in patients with HER2-positive early-stage breast cancer.

The APHINITY trial enrolled patients with node-positive or high-risk node-negative operative breast cancer who received either pertuzumab plus trastuzumab and chemotherapy or placebo and standard adjuvant chemotherapy plus 1 year of trastuzumab. 

Updated data from the interim second analysis of the trial continued to show the benefit of adding pertuzumab to trastuzumab and chemotherapy in the adjuvant setting, which is promising, says Han. Results showed a continued benefit with regard to invasive disease-free survival. Additionally, the degree of benefit was even higher than what had been presented a few years ago, which Han says is very encouraging. 

It is too early to see an overall survival (OS) benefit with the approach. Longer-term follow-up is needed, but these data are highly anticipated, according to Han. 

Additionally, benefit was observed in patients with high-risk disease, concludes Han. 

Videos

Heather ​S. Han, MD, discusses the benefit of adding pertuzumab to trastuzumab and chemotherapy in the phase 3 APHINITY trial in patients with HER2-positive early-stage breast cancer.

Dr. Han on the APHINITY Trial in HER2+ Early-Stage Breast Cancer

Heather ​S. Han, MD, medical oncologist and research director of Breast Oncology, Moffitt Cancer Center, discusses the importance of risk stratification in HER2-positive breast cancer.

The field of HER2-positive breast cancer is moving toward risk stratification as a means to personalize therapy for individual patients, Han explains. Moreover, it is known that utilizing a one-size-fits-all intensive treatment approach is not beneficial for all patients. 

In order to optimize therapy for patients, the field is in need of biomarkers to stratify individual risk, says Han. Currently, disease stage at presentation, including tumor size and lymph node status, is the only confirmed risk-stratifying biomarker in the space. 

Other factors such as the presence of residual tumor following neoadjuvant therapy and whether the patient underwent preoperative therapy are also considered, concludes Han.

Heather ​S. Han, MD, discusses the importance of risk stratification in HER2-positive breast cancer.  



Dr. Han on the Importance of Risk Stratification in HER2+ Breast Cancer 

Heather ​S. Han, MD, medical oncologist and research director of Breast Oncology, Moffitt Cancer Center, discusses the importance of pathologic complete response (pCR) in breast cancer.

Patients with breast cancer who achieve a pCR following neoadjuvant therapy often have a better outcome compared with patients who do not, Han says. Moreover, pCR has been established as an important prognostic marker in breast cancer. 

Today, pCR continues to be used as a surrogate marker for patients with breast cancer ​following neoadjuvant therapy, explains Han.

Based on available data, the field can better determine the most optimal adjuvant treatment option for patients, Han concludes.

Heather ​S. Han, MD, discusses the importance of pathologic complete response in breast cancer.

Dr. Han on the Importance of pCR in Breast Cancer

Heather S. Han, MD, research director, medical oncologist, Department of Breast Oncology, Moffitt Cancer Center, discusses the differences between CDK 4/6 inhibitors and their efficacy as both single- and combination agents.

The efficacy of CDK 4/6 inhibitors are fairly similar. All 3 inhibitors improve progression-free survival in the first- and second-line settings in hormone receptor-positive metastatic breast cancer. The toxicity profiles, however, are slightly different. Abemaciclib (Verzenio) is commonly associated with diarrhea, gastrointestinal toxicity, and fatigue. Riboclicib (Kisqali) and palbociclib (Ibrance) are more similar in that they can lead to neutropenia.

Abemaciclib is the only therapy to be approved as a single-agent at a slightly higher continuous dosing schedule of 200 mg. Its approval was based on the data from the MONARCH 1 trial. Abemaciclib can be used continuously at either 150 mg or 200 mg twice a day, or in combination with endocrine therapy, she says.

Heather S. Han, MD, research director, medical oncologist, Department of Breast Oncology, Moffitt Cancer Center, discusses the differences between CDK 4/6 inhibitors, and their efficacy as both single- and combination agents.

Heather S. Han, MD

Articles

Dr. Han on the APHINITY Trial in HER2+ Early-Stage Breast Cancer

Dr. Han on the Importance of Risk Stratification in HER2+ Breast Cancer

Dr. Han on the Importance of pCR in Breast Cancer

Dr. Han on the Differences Between CDK 4/6 Inhibitors in ER+ Breast Cancer