Dr. Tripathy on Neoadjuvant Agents for HER2+ Breast Cancer

Debu Tripathy, MD, chair of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, discusses agents that are available and in development in the neoadjuvant setting as treatments for patients with HER2-positive breast cancer.

There are several drugs that are new kinase inhibitors that are not yet available for neoadjuvant use. However, Tripathy explains, 1 agent that is an exception is neratinib, a HER2-targeted agent that was tested in the I-SPY 2 trial and showed a benefit in patients with triple-negative breast cancer, as well.

MK2206 is an AKT inhibitor that, when added to trastuzumab (Herceptin), showed an improvement in the pathological complete response (pCR) rate. These findings were also observed in the I-SPY 2 program. These are interesting areas in which to combine such agents with HER2-targeted agents, Tripathy explains. Studies are also exploring combinations with immunotherapy in HER2-positive disease to determine whether the pCR rates can be improved.

Some newer agents that are being used in the metastatic setting will likely make their way into the neoadjuvant setting as well, Tripathy adds.