Dr. Tripathy on Treatment De-Escalation in HER2+ Breast Cancer

Debu Tripathy, MD, professor of medicine and chair of the Department of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center, discusses treatment de-escalation in HER2-positive breast cancer.

Patients with clinical stage I HER2-positive breast cancer may be eligible for de-escalated dosing of weekly paclitaxel and trastuzumab (Herceptin), says Tripathy.

Prior to de-escalati​on, patients will typically undergo up​-front surgery to confirm that their disease is not being up​staged​, says Tripathy.

If the patient has confirmed early-stage disease, or the​ir tumor is under 3 cm, therapy de-escalation can be considered per data from the phase 2 APT trial, explains Tripathy.

The field is ​currently awaiting ​the randomized data from the ​phase 2 ATEMPT trial to determine whether ado-trastuzumab emtansine (T-DM1; Kadcyla) could be de-escalated, Tripathy concludes.