Dr. Tripathy on Standard and Emerging Treatment Advances for HER2+ Breast Cancer

Debu Tripathy, MD, chair of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, discusses standard and emerging advances in the treatment of patients with HER2-positive breast cancer.

What is the best standard of care currently for neoadjuvant treatment of patients with HER2-positive breast cancer? The first decision should be whether patients even receive neoadjuvant therapy, but Tripathy explains that patients with stage I disease may benefit more by undergoing upfront surgery alone. In addition, they would receive less aggressive therapy with fewer side effects, such as paclitaxel, followed by trastuzumab (Herceptin) for 1 year. For patients with stage II disease or greater, pertuzumab (Perjeta) is a standard of care that is preferable because there is better associated downstaging, he adds.

With preliminary results of the APHINITY trial released, which showed that pertuzumab added to trastuzumab improves disease-free survival (DFS), Tripathy says this regimen might also improve pathologic complete response and overall survival.