Panelists discuss how treatment strategies for triple-positive breast cancer (hormone receptor [HR] positive and HER2 positive) differ from those for hormone receptor–negative, HER2-positive disease, with emphasis on balancing endocrine therapy, HER2-targeted therapy, and chemotherapy.
Video Player is loading.
Current Time 0:00
/
Duration 0:00
Loaded: 0%
Stream Type LIVE
Remaining Time -0:00
1x
2x
1.75x
1.5x
1.25x
1x, selected
0.75x
0.5x
Chapters
descriptions off, selected
captions settings, opens captions settings dialog
captions off, selected
This is a modal window.
Beginning of dialog window. Escape will cancel and close the window.
End of dialog window.
This is a modal window. This modal can be closed by pressing the Escape key or activating the close button.
Treatment Strategies for Triple-Positive Breast Cancer
Panel Introduction
Moderators and Panelists:
Dr Kelly McCann, MD, PhD - Breast medical oncologist and assistant professor at the David Geffen School of Medicine at UCLA
Dr Gregory Vidal, MD, PhD - Breast medical oncologist at West Cancer Center and Research Institute; associate professor at the University of Tennessee Health Sciences Center; director of clinical research at West Cancer Center
Key Themes:
Triple-positive breast cancer characteristics
Defined as HR-positive and HER2-positive breast cancer
Shows different prognosis and treatment response compared with HR-negative, HER2-positive disease
According to SEER database, has better prognosis than HR-negative, HER2-positive breast cancer
About half exhibit luminal A or B phenotype (Kim et al, 2019)
Standard treatment approaches
Standard of care includes taxane with pertuzumab and trastuzumab
Chemotherapy eventually discontinued with antiestrogen therapy added to the backbone
PATINA study showed adding cyclin-dependent kinase (CDK) 4/6 inhibitor to antiestrogen therapy resulted in progression-free survival benefit
CDK 4/6 inhibitors and triplet therapy
monarcHER trial demonstrated better outcomes with CDK 4/6 inhibitor plus antiestrogen therapy and trastuzumab compared with chemotherapy and trastuzumab
PATINA trial showed adding palbociclib to maintenance therapy improved progression-free survival (44.3 months vs 29.1 months)
Toxicity considerations include neutropenia, gastrointestinal adverse effects, fatigue, menopausal symptoms, and cardiac monitoring requirements
Notable Insights:
Dr Vidal noted: “Standard of care in this setting is really a taxane with pertuzumab and trastuzumab with chemotherapy eventually dropping off, and with the addition of antiestrogen therapy to that backbone.”
Dr McCann emphasized: “I think it’s very important to remember that even though we think of triple-positive cancers as predominantly HER2 driven, that’s not necessarily true. There’s actually a lot of crosstalk between HER2 and the estrogen receptor pathways in terms of growth signals.”