Today we wanted to point to an outstanding interview with Dr. Nicholas P. McAndrew, an expert in breast cancer treatment.
He recently shared insights on the evolving strategies for managing HER2-positive metastatic breast cancer. This comes in the wake of new research findings that are shaping the way doctors approach treatment for this specific type of breast cancer.
He describes two key studies were highlighted. The first, the KATHERINE trial, showed that using adjuvant ado-trastuzumab emtansine (also known as T-DM1 or Kadcyla) significantly improves the chances of survival without cancer returning, compared to using trastuzumab (Herceptin) alone, in patients who still had cancer signs after initial treatment.
These findings were especially notable because they’ve held up over seven years, indicating a long-term benefit.
The second study, HER2CLIMB-02, demonstrated that adding tucatinib (Tukysa) to T-DM1 enhances the time patients live without their cancer worsening, especially for those with brain metastases—a common and challenging complication.
This research supports further exploration of tucatinib in combination with other treatments, including its potential use earlier in the treatment process.
In the interview with OncLive’s Courtney Flaherty, Dr. McAndrew emphasized the continuous evolution in breast cancer research, highlighting the importance of staying updated with the latest findings to improve patient outcomes. He also discussed the impact of these studies on current practice, noting that they help identify which patients might benefit from more intensive treatment after initial therapy and explore less traditional treatment routes that could reduce side effects without compromising effectiveness.
For instance, ongoing studies are investigating the optimal sequence of using tucatinib and how it can be integrated with other treatments, such as fam-trastuzumab-deruxtecan-nxki (Enhertu; T-DXd), in various stages of breast cancer. This is crucial as the treatment landscape rapidly changes, with newer therapies potentially becoming preferred options based on their effectiveness.
Furthermore, McAndrew pointed out the potential of neoadjuvant (pre-surgery) trials to refine treatment personalization. He referenced the PHERGain study, which tests a strategy to minimize chemotherapy use in certain patients, relying on targeted therapy alone for those who respond well early on.
This approach aims to maintain high survival rates while avoiding chemotherapy’s side effects for some patients, showcasing a move towards more tailored and less invasive treatment plans.
Definitely worth a read or a listen for patients and clinicians alike.
