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Kelly McCann, MD, PhD, a medical oncologist in the Breast Cancer Research Group at the University of California, Los Angeles, discusses ongoing research in the field of HER2-positive breast cancer.
Kelly McCann, MD, PhD, a medical oncologist in the Breast Cancer Research Group at the University of California, Los Angeles, discusses ongoing research in the field of HER2-positive breast cancer.
In addition to a lot of the escalation therapies such as pertuzumab (Perjeta) plus trastuzumab (Herceptin) in the adjuvant setting, and adding neratinib (Nerlynx) to long-term chemotherapy plus 1 year of trastuzumab, physicians are also looking at de-escalation therapies for tumors that are much smaller. These include trials with just a taxane plus trastuzumab with or without pertuzumab. Those have been promising, but long-term overall survival and disease-free survival has not been released yet. Therefore, physicians cannot make conclusions about that, says McCann.
For very small tumors—less than 1 cm—some physicians are starting to use a taxane plus trastuzumab for node-negative patients, says McCann. However, physicians know that these tumors have a chance to recur, so not doing any therapy at all is ill advised. Physicians also know that trastuzumab alone is not as potent and efficacious as trastuzumab plus chemotherapy.
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