Dr. Paplomata on the Role of Tucatinib/Trastuzumab/Capecitabine in HER2+ Metastatic Breast Cancer

Elisavet Paplomata, MD, assistant professor, University of Wisconsin School of Medicine and Public Health, oncologist, University of Wisconsin Carbone Cancer Center, discusses the role of tucatinib (Tukysa) ​in combination with trastuzumab (Herceptin) and capecitabine in HER2-positive metastatic breast cancer.

For patients with HER2-positive metastatic breast cancer who progress on second-line ado-trastuzumab emtansine (Kadcyla; T-DM1), the tucatinib-based regimen is a potential third-line option, Paplomata ​says.

Notably, as displayed in the ​phase 2 HER2CLIMB trial, this regimen is well ​tolerated and has a manageable safety profile​, Paplomata explains. Approximately 80% of patients experienced diarrhea ​with the combination, but the toxicity was well managed ​with antidiarrheal medication.

Additionally, elevated liver enzymes, which were reported in some patients, were well managed with dose interruptions and reductions, adds Paplomata.

​The triplet also demonstrated encouraging efficacy in patients with brain metastases and should be considered for patients in that setting, Paplomata concludes.