Melody A. Cobleigh, MD, a professor of medical oncology at Rush University Medical Center, discusses the focus of future research in HER2-positive breast cancer.

One of the goals of future research should be to eliminate the need for chemotherapy, says Cobleigh. That may become a reality with antibody-drug conjugates (ADCs), which are essentially a less toxic form of traditional cytotoxics. Additionally, some of the bispecific antibodies that are trying to bring the immune system to the HER2 receptor is a very promising area of research.

For patients with hormone receptor (HR)-positive, HER2-positive breast cancer, there is an interesting trial in which investigators are looking at an all-oral therapy in metastatic breast cancer. Specifically, the trial is testing the combination of palbociclib (Ibrance) plus a TKI. These types of approaches are important, as approximately 70% of patients will present with metastatic HER2-positive breast cancer that is positive for both HR and HER2.

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Dr. Cobleigh on the Focus of Future Research in HER2+ Breast Cancer

Melody A. Cobleigh, MD, professor of medical oncology at Rush University Medical Center, discusses antibody—drug conjugates (ADCs) under development in HER2-positive breast cancer.

There are several ADCs in development. For example, the Daiichi Sankyo compound, known as [fam-] trastuzumab deruxtecan (DS-8201), has shown some very promising results, says Cobleigh. According to the manufacturer, an accelerated filing of a biologics license application is planned for the first half of 2019 for DS-8201 as a treatment for patients with HER2-positive metastatic breast cancer previously treated with ado-trastuzumab emtansine (T-DM1; Kadcyla).

There are 3 ongoing phase III trials that will inform whether or not the drug will end up in the paradigm, adds Cobleigh. The unique aspect about ADCs is that they offer a safer way to give chemotherapy. However, they are not without toxicity. Understanding better ways to deliver these compounds to reduce toxicity is the focus of a lot of research right now, she concludes.

Melody A. Cobleigh, MD, professor of medical oncology at Rush University Medical Center, discusses antibody–drug conjugates (ADCs) under development in HER2-positive breast cancer.

Melody A. Cobleigh, MD

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Dr. Cobleigh on the Focus of Future Research in HER2+ Breast Cancer

Dr. Cobleigh on Antibody-Drug Conjugates in Development in HER2+ Breast Cancer