Updates in the Treatment of HR+/HER2- Breast Cancer - Episode 3

Current Practices for Targeted Therapies and Molecular Testing for HR+/HER2- Metastatic Breast Cancer

Panelists discuss how the latest NCCN guidelines for targeted therapies and biomarker testing in advanced/metastatic breast cancer highlight the importance of biomarker-driven approaches, with particular emphasis on the need for next-generation sequencing testing in the first-line setting, the implications of HER2-low classification, and how the recent FDA approval of a PI3K inhibitor may impact testing practices and treatment strategies.

Video content above is prompted by the following:

  • Please briefly mention the latest NCCN guidelines for targeted therapies and associated biomarker testing.
  • How does biomarker testing differ in advanced/metastatic breast cancer from early-stage disease?
  • What should be considered when testing in the first line for advanced disease?
  • Is there a need for next-generation sequencing testing before first-line metastatic disease? (eg, BRCA, PIK3CA, PD-L1, NTRK, microsatellite instability–high/mismatch repair deficiency, high tumor mutational burden) 
  • Will the recent FDA approval of a PI3K inhibitor affect your testing practice?
  • For a patient whose cancer has progressed, do you obtain a new biopsy or go back to the original sample? Why?
  • How has immunohistochemistry (IHC) testing changed with the addition of HER2-low to NCCN guidelines?
  • How are you interpreting IHC staining results for HER2-low?
  • How are results reported? Are you given a percentage of staining, or are you given the category of HER2-low?