Nancy E. Davidson, MD, 2021 Giants of Cancer Care® award winner in Breast Cancer, senior vice president, director, professor, Clinical Research Division, Raisbeck Endowed Chair for Collaborative Research, Fred Hutchinson Cancer Research Center, president, executive director, Seattle Cancer Care Alliance, discusses the future of HER2-targeted therapies in breast cancer.

Based on results from the phase 3 DESTINY-Breast03 trial (NCT03529110), fam-trastuzumab deruxtecan-nxki (Enhertu) is currently getting the majority of the attention as its role in treatment is determined, Davidson says. However, tucatinib (Tukysa) remains an area of interest to determine how it be applied as an anti-HER2 therapy, Davidson explains.

Research is being conducted to better understand the best role and sequence for each agent, Davidson continues. Therapies that are the most effective and well-tolerated in the metastatic setting could eventually be applied in the early-stage settings, Davidson says. Using these agents in the early stage for patients who are HER2-positive at the time of presentation could allow them to undergo primary therapy and not be troubled by the disease again, Davidson concludes.

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Nancy E. Davidson, MD, discusses the future of HER2-targeted therapies in breast cancer.


Dr. Davidson on the Future of HER2-Targeted Therapies in Breast Cancer

Nancy E. Davidson, MD, the 2021 Giants of Cancer Care® award winner in Breast Cancer, senior vice president, director and professor, Clinical Research Division, Fred Hutch; Raisbeck Endowed Chair for Collaborative Research, Fred Hutch; and president and executive director, Seattle Cancer Care Alliance; shares how to leverage imaging technologies to inform treatment decisions in patients with breast cancer. 

Although there is much interest in both tissue and blood-born biomarkers of response in breast cancer, there has also been an increased interest in functional imaging techniques, according to Davidson. Currently, at the Fred Hutchinson Cancer Research Center, there is research being done to determine whether imaging technologies can be used to understand the biologic capacity of cancer in the patient. Efforts are being made to understand if this information can be utilized to determine whether a patient will respond to a particular treatment, Davidson adds. 

For example, new PET tracers make it possible to define hormone-responsive breast cancers more easily, Davidson notes. This is valuable, as it would shed light on a patient’s likelihood of responding to hormone therapy, and potentially inform whether focus should shift to other treatments that could be more beneficial, Davidson adds. This understanding would help prevent unnecessary exposure to hormone therapy and potential associated toxicities, Davidson concludes.

Nancy E. Davidson, MD, shares how to leverage imaging technologies to inform treatment decisions in patients with breast cancer. 


Dr. Davidson on Leveraging Imaging Technologies to Inform Clinical Decisions in Breast Cancer

Nancy E. Davidson, MD, director, University of Pittsburgh Cancer Institute and UPMC Cancer Centers, discusses two methods of screening for ovarian cancer, which have both been proven to be ineffective.

The two primary methods of screening for ovarian cancer include a CA-125 blood test and transvaginal ultrasound. These methods have been studied in several large international trials in women at risk for developing ovarian cancer. Overwhelmingly they found that although these methods were able to find some cancers the number of false positives and needless surgeries outweighed their potential benefits.

Davidson notes that it is important to always practice evidence-based medicine; this includes the need to weigh potential benefits with risks for any procedure. Physicians should discuss the risks with their patients while noting that in some cases, for patients at high-risk, these screening procedures may still be valuable.

Dr. Nancy Davidson, from the University of Pittsburgh Cancer Institute, on Screening for Ovarian Cancer 

Dr. Davidson on Screening for Ovarian Cancer

Nancy E. Davidson, MD, director, University of Pittsburgh Cancer Institute and UPMC Cancer Centers, discusses breast cancer chemoprevention, which uses pharmaceuticals to prevent or delay the development of cancer.

Davidson explains that a great deal of research has been done into chemoprevention in breast cancer, mostly with the selective estrogen receptor modulators (SERMs), tamoxifen and raloxifene. There have been numerous randomized trials that demonstrated positive results. However, these trials did not produce the widespread adaptation of SERMs for chemoprevention.

The agents tamoxifen and raloxifene are both approved for breast cancer risk reduction in high-risk patients. There is information available that suggest aromatase inhibitors can also prevent breast cancer, but they are not an FDA approved intervention.

According to Davidson, the puzzle of chemoprevention is that trials with tens of thousands of women over decades have not been applied, despite positive results with several agents.

Dr. Nancy Davidson, from the University of Pittsburgh Cancer Institute, Discusses Breast Cancer Chemoprevention 

Nancy E. Davidson, MD

Articles

Dr. Davidson on the Future of HER2-Targeted Therapies in Breast Cancer

Dr. Davidson on Leveraging Imaging Technologies to Inform Clinical Decisions in Breast Cancer

Dr. Davidson on Screening for Ovarian Cancer

Dr. Davidson Discusses Breast Cancer Chemoprevention