Dr. Tolaney on Tailoring HER2-Directed Therapy in Breast Cancer

Sara M. Tolaney, MD, MPH, associate director, Susan F. Smith Center for Women's Cancers, Dana-Farber Cancer Institute, and associate professor of medicine, Harvard Medical School, discusses tailoring HER2-directed therapies in the treatment of patients with breast cancer. 

New developments in HER2-directed therapies have made a significant impact on the treatment of this patient population, according to Tolaney. However, as more new therapies are introduced, it is important to consider how to best personalize treatment for each patient, Tolaney says. This entails attempting to de-escalate treatment by giving less toxic therapy to patients who have lower-risk disease, and conversely, to escalate treatment for those with higher-risk disease, Tolaney explains. 

For example, those with small, HER2-positive, node-negative breast cancers, may be optimal candidates to receive less therapy, Tolaney notes. Additionally, now that better HER2-directed agents are available, de-escalated approaches may prove to be more feasible. However, although significant updates have been made in this arena, there is always room for improvement, Tolaney concludes.