Dr. Robson on the Potential Utility of Tucatinib in HER2+ Breast Cancer

Mark E. Robson, MD, chief, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, discusses the potential utility of tucatinib in the treatment of patients with HER2-positive breast cancer.

In February 2020, the FDA granted a priority review designation to a new drug application (NDA) for tucatinib for use in combination with trastuzumab (Herceptin) and capecitabine (Xeloda) for the treatment of patients with unresectable locally advanced or metastatic HER2-positive breast cancer, including patients with brain metastases, following ≥3 prior lines of HER2-directed agents separately or in combination, in the neoadjuvant, adjuvant, or metastatic setting.

The utility of tucatinib could be influenced by that of neratinib (Nerlynx), explains Robson. In February 2020, the FDA approved a supplemental NDA for neratinib for use in combination with capecitabine for the treatment of patients with advanced or metastatic HER2-positive breast cancer who received ≥2 prior anti—HER2-based regimens in the metastatic setting.

While there has not been a head-to-head trial with the agents, tucatinib could have greater utility in patients with brain metastases, says Robson. Additionally, tucatinib appears to be better tolerated.

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