Optimizing Care in HER2+ Breast Cancer: Integrating Fertility Preservation and Advanced Treatment Approaches

Kelly E. McCann, MD, PhD; and Gregory Vidal, MD, PhD, discuss how triple-positive breast cancer (hormone receptor positive and HER2 positive) requires specialized treatment approaches, including standard taxane with pertuzumab-trastuzumab combinations, the integration of CDK 4/6 inhibitors, considerations for ovarian suppression in premenopausal patients, and sequential therapy options for metastatic disease including antibody-drug conjugates and tyrosine kinase inhibitors.

EP. 1: Optimizing Therapy in HR+/HER2+ Breast Cancer: Balancing Endocrine, HER2-Targeted, and Chemotherapy Options

April 28th 2025

Panelists discuss how treatment strategies for triple-positive breast cancer (hormone receptor [HR] positive and HER2 positive) differ from those for hormone receptor–negative, HER2-positive disease, with emphasis on balancing endocrine therapy, HER2-targeted therapy, and chemotherapy.

EP. 2: Treatment Planning for HER2+ Breast Cancer: The Role of Ovarian Function Suppression

April 28th 2025

Panelists discuss how ovarian suppression combined with endocrine therapy shows benefits for premenopausal patients with triple-positive breast cancer, particularly in younger, high-risk populations.

EP. 3: HER2+ Breast Cancer Management: Navigating GnRH Agonist Choice and Patient Experience

May 9th 2025

Panelists discuss how different gonadotropin-releasing hormone (GnRH) agonists like leuprolide and goserelin are equally efficacious for ovarian function suppression but differ in administration methods, needle size, and patient comfort.

EP. 4: Navigating Early-Line Treatment Options for HER2+ Metastatic Breast Cancer

May 9th 2025

Panelists discuss how the treatment landscape for early HER2-positive metastatic breast cancer has evolved, with taxane-pertuzumab-trastuzumab as first-line standard of care and T-DXd supplanting T-DM1 as the preferred second-line treatment.

EP. 5: Expert Insights on Third-Line Treatment Decisions for HER2+ Metastatic Breast Cancer

May 16th 2025

Panelists discuss how third-line treatment options after T-DXd progression include T-DM1 and the HER2CLIMB regimen (tucatinib-capecitabine-trastuzumab), with consideration of brain metastases as a key factor in treatment selection.

EP. 6: Navigating the Data: Later-Line Systemic Therapies for HER2+ Metastatic Breast Cancer

May 16th 2025

Panelists discuss how fourth-line treatment options include margetuximab (which interacts better with the immune system), neratinib-capecitabine (an irreversible pan-HER inhibitor), and antibody-drug conjugates (ADCs) with different payloads, though toxicity profiles must be considered.

EP. 7: Patient-Centered Decisions and Evolving Treatment Landscape for HER2+ Metastatic Breast Cancer

May 23rd 2025

Panelists discuss how treatment decisions in later-line settings should incorporate clinical trials, patient preferences regarding quality of life, medication scheduling, financial considerations, and previous adverse effect experiences, while also addressing special considerations for brain metastases.

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