Treatment for Metastatic Breast Cancer

Rita Nanda, MD: Hi, my name is Rita Nanda, and I’m a breast medical oncologist from the University of Chicago Medicine. As you all know, the standard of care frontline treatment for metastatic HER2-positive breast cancer has been the combination of a taxane, trastuzumab, and pertuzumab, based on the CLEOPATRA trial, which demonstrated a significant improvement in progression-free survival and overall survival. Beyond frontline like, the standard of care has generally been T-DM1 [trastuzumab emtansine], based on the EMILIA trial. This showed that T-DM1 was superior to capecitabine plus lapatinib in that second-line setting.

Trastuzumab emtansine has been the mainstay of second-line treatment after progression on dual HER2-targeted therapy and a taxane, based on the EMILIA trial, which demonstrated an improvement in progression-free survival and overall survival with T-DM1, as compared to capecitabine and lapatanib.

Looking to the future, we have a handful of new drugs that have recently been FDA approved. Tucatinib is now FDA approved to be given in conjunction with capecitabine and trastuzumab, as is T-DXd or DS-8201, also called trastuzumab deruxtecan. Trastuzumab deruxtecan is also approved in the third-line setting and beyond. A lot of new, exciting drugs that have been FDA approved in the past few months are offering a lot of hope to our patients with advanced HER2-positive breast cancer.

Transcript Edited for Clarity