Insight

Jan 23, 2025, 09:32

Scientific Insights from Prof. Hope Rugo: Advancements in Metastatic HER2+ Breast Cancer Therapy

During the recent Breast, Gynecological & Immuno-Oncology International Cancer Conference, Prof. Hope Rugo presented critical updates on the evolving therapeutic landscape for metastatic HER2+ breast cancer (BC).

Here’s an overview of key highlights:

1. Approach to Therapy for HER2+ BC:

1st Line: Taxane + trastuzumab + pertuzumab (includes maintenance therapy with ET/palbociclib in ER+ cases).
2nd Line: Trastuzumab deruxtecan or tucatinib-based regimens.
3rd Line and Beyond: Options include T-DM1, margetuximab + chemotherapy, or trastuzumab + lapatinib. Specific regimens are tailored to patient needs, including CNS disease considerations (e.g., neratinib + capecitabine).

2. Antibody-Drug Conjugates (ADCs):

ADCs have shown remarkable efficacy across all breast cancer subsets, becoming a cornerstone of treatment.
Two ADCs are approved for HER2+ disease and three for HER2-low, ER+, and TNBC.
Despite well-recognized chemotherapy-related toxicities, unique ADC toxicities (e.g., ILD) require proactive management.

3. Emerging Trends:

ADCs are now being integrated into earlier lines of therapy and studied in early-stage disease.
Key questions include:
Efficacy of sequencing therapies: Is there an optimal order of ADC administration?
Mechanisms of resistance: How can they be overcome to sustain efficacy?

Looking Forward:

The rapid progression in HER2+ BC treatments, especially with ADCs, highlights the need for personalized strategies. Proactive toxicity management and addressing sequencing/resistance questions will be pivotal in maximizing patient outcomes.

This session emphasizes the global effort to refine breast cancer care and highlights the game-changing potential of ADCs in improving survival rates across different patient populations.