Dr McCann on the Importance of Integrating Patient Preferences Into Treatment Planning for Patients With HER2+ Breast Cancer

“As we develop more knowledge about the molecular biology and understand the nuances of a patient’s response to treatment, it’s going to be increasingly hard trying to figure out how we’re going to sequence these therapies, and we [have to keep in mind] what’s best for the patient.”

Kelly McCann, MD, PhD, an associate clinical professor of medicine in the Division of Hematology/Oncology at UCLA Health, discussed the importance of considering patient preferences when planning treatments for patients with HER2-positive breast cancer.

As therapeutic options expand and molecular biology increasingly informs decision-making, McCann explained that selecting and sequencing therapies will require careful consideration of both efficacy and the patient experience. According to McCann, although biomarkers such as estrogen receptor (ER) positivity status, progesterone receptor positivity status, and HER2 positivity status have historically guided treatment selection, advances in molecular profiling have created more complex clinical scenarios. Multiple agents and combinations are becoming available, and oncologists must determine how best to tailor therapy to each patient’s biology, as well as prioritize quality of life (QOL), she reported. She emphasized that patients ultimately have to take and tolerate the therapy, underscoring the value of shared decision-making.

McCann noted that treatment delivery can significantly influence patient preferences. For example, many patients may favor oral selective ER degraders (SERDs) over fulvestrant (Faslodex) injections, which are administered intramuscularly every 28 days, provided that safety and efficacy are comparable, she emphasized. Offering oral agents may reduce treatment burden and improve satisfaction, she stated. Presenting patients with these options and discussing their values and priorities is essential, she added.

Emerging data from combination trials evaluating oral SERDs with agents currently used alongside fulvestrant may further shape clinical practice, she continued. If ongoing studies confirm safety and efficacy, these regimens could shift practice patterns toward oral SERD–based combinations, McCann explained.