Matthew Kurian, Assistant Professor of Medicine at the University of Kentucky College of Medicine and Physician at St. Elizabeth Healthcare, shared a post on LinkedIn:
“Breakthrough moment in HER2+ metastatic breast cancer.
The FDA’s Approval for front-line T-DXd + pertuzumab is an exciting signal – but the real question is who should receive this early?
Not everyone in my opinion. And that’s okay.
Where I see this being most impactful:
• Younger patients with aggressive biology
• Visceral crisis or organ dysfunction
• High tumor burden needing rapid, deep responses
• PIK3CA-mutant disease
• Brain metastases, where early control matters most
Is there still a role for THP → maintenance HP / PHESGO?
Absolutely. Many patients value a chemo-free maintenance approach, and that remains critical. The DEMETHER trial will hopefully help clarify duration — something we still don’t have great data on. Until then, I treat to best clinical response as long as tolerance allows especially with DB09 data.
HER2CLIMB-05 & tucatinib?
Very promising data presented by Erika Hamilton, MD, FASCO at San Antonio Breast Cancer Symposium 2025. Chemo-sparing strategies matter, and tucatinib’s CNS activity may help prevent future brain metastases in the right patients. More follow up to come, but I am quite excited about this strategy!
Bottom line: this isn’t about replacing one standard – it’s about personalizing therapy for the patients who need the most early depth of response, while preserving quality of life for others.”
More posts featuring Matthew Kurian on OncoDaily.
You Can Also Read: FDA Approves Fam-Trastuzumab Deruxtecan-nxki With Pertuzumab for First-Line Treatment of HER2-Positive Metastatic Breast Cancer
