Although there has been considerable progress in the treatment of early stage HER2+ breast cancer, there are still areas of unmet need. Specifically, there are patients that still go on to develop metastatic disease despite optimal neoadjuvant and adjuvant therapy. Moreover, a good percentage of these patients are relapsing in the CNS, despite the gains we have achieved with T-DM1 in the post neoadjuvant setting. In the metastatic setting, first line therapy with a taxane, trastuzumab and pertuzumab has become standard. However, with the approval of several other agents optimizing sequencing strategies remains an area of active investigation. Balancing side effects, dosing schedules as well as efficacy of these agents continues to be challenging. Patient goals of care are also being given a much more significant place in therapeutic decision making.
Reshma Mahtani, DO, from Sylvester Comprehensive Cancer Center, and Lee Schwartzberg, MD, FACP, from West Cancer Center & Research Institute, discuss the newest information on data and supporting data leading to better selection of treatment for early stage and metastatic HER2+ breast cancer.
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