Dr. Kimmick on the Evolving HER2+ Breast Cancer Treatment Paradigm

Gretchen G. Kimmick, MD, MS, professor of medicine, Duke University School of Medicine, ​member, Duke Cancer Institute, discusses the quickly evolving treatment paradigm for patients with HER2-positive breast cancer. 

Efforts are being made to provide the most beneficial options for those with either early-stage or metastatic disease, according to Kimmick. Because new agents are being developed so rapidly, treatment decisions in the adjuvant setting have become more complex, Kimmick says.

Questions remain regarding when patients should receive either neoadjuvant therapy or adjuvant therapy after neoadjuvant therapy when residual disease is detected, Kimmick adds. Most patients with HER2-positive disease will receive neoadjuvant therapy due to symptoms associated with fast-growing tumors, so surgeons should be prepared for this treatment, Kimmick explains. In the adjuvant setting, ado-trastuzumab emtansine (T-DM1; Kadcyla) is demonstrating better efficacy than trastuzumab (Herceptin) alone. Other novel agents are also under investigation, Kimmick concludes.