Dr. Tolaney on Neoadjuvant HER2-Directed Therapy

Sara M. Tolaney, MD, MPH, instructor of medicine, Harvard Medical School, attending physician of medical oncology, Dana-Farber Cancer Institute, discusses neoadjuvant HER2-directed therapy.

Since 2013, pertuzumab (Perjeta)-based chemotherapy has primarily been used for patients in the preoperative setting based on the results of the NeoSphere and TRYPHAENA trials, explains Tolaney. However, now there are data in the adjuvant setting looking at the long-term benefits of pertuzumab with the APHINITY trial. The data suggest that the disease-free survival benefit appears to be small with a 1.7% difference.

The approach in the neoadjuvant setting is going to change, according to Tolaney. Pertuzumab-based chemotherapy was being used for the majority of tumors that were more than 2 centimeters, but that may no longer be necessary since not all patients are going to gain long-term benefits from pertuzumab.