Sep 9, 2019

Breast Cancer Update, Issue 2, 2019 — Part 1: Our interview with Dr Krop highlights the following topics as well as cases from his practice:

• Case: A patient in her late 40s with ER-positive, HER2-positive, node-positive breast cancer experiences a near complete response after treatment with neoadjuvant doxorubicin, cyclophosphamide, paclitaxel, trastuzumab and pertuzumab (AC-THP) (00:00)
• Choice of neoadjuvant chemotherapy for patients with HER2-positive breast cancer (01:43)
• Pertuzumab toxicity with or without chemotherapy (05:25)
• Management of the axilla in patients with clinically node-positive breast cancer who achieve a pathologic complete response to neoadjuvant systemic therapy (07:42)
• Design and results from the Phase III KATHERINE study evaluating adjuvant T-DM1 versus trastuzumab for patients with HER2-positive early breast cancer and residual disease after neoadjuvant treatment (09:46)
• Perspective on the benefits and risks of T-DM1/pertuzumab versus T-DM1 alone as adjuvant therapy (13:04)
• Benefit of T-DM1 compared to trastuzumab irrespective of the extent of residual disease at surgery in the KATHERINE trial (14:45)
• Clinical implications of the KATHERINE trial results (17:48)
• Results from the Phase III KRISTINE study evaluating neoadjuvant docetaxel, carboplatin, trastuzumab and pertuzumab (TCHP) versus T-DM1 and pertuzumab for HER2-positive breast cancer (19:42)
• Use of cold caps to reduce the risk of alopecia with chemotherapy (23:53)
• Side-effect profile of T-DM1 in the adjuvant KATHERINE trial (25:27)
• Perspective on the use of neratinib in the post-(neo)adjuvant and metastatic settings (29:42)
• APHINITY: Phase III study evaluating adjuvant pertuzumab in combination with trastuzumab and chemotherapy for HER2-positive early breast cancer (34:08)
• Biomarker analysis of the APHINITY trial: Genomic correlates of response to adjuvant pertuzumab with trastuzumab for HER2-positive breast cancer (36:15)
• Emerging data with immune checkpoint inhibitors in combination with HER2-targeted therapy for HER2-positive breast cancer (40:22)
• HER2 heterogeneity as a predictor of response to neoadjuvant T-DM1 and pertuzumab: Results from a prospective clinical trial (42:09)
• Changes in HER2 status during disease progression (45:50)
• Case: A woman in her early 60s with de novo ER-positive, HER2-positive metastatic breast cancer (mBC) experiences disease progression in the brain during treatment with T-DM1 (47:35)
• Activity of T-DM1 in patients with brain metastases (48:58)
• Efficacy and tolerability of tucatinib for HER2-positive mBC; ongoing Phase II HER2CLIMB study evaluating tucatinib versus placebo, each in combination with capecitabine and trastuzumab (52:41)
• Emerging data with neratinib and capecitabine for patients with HER2-positive breast cancer and brain metastases (55:23)
• Response to CDK4/6 inhibitors in patients with ER-positive, HER2-positive mBC (58:38)
• Case: A woman in her early 30s with HER2-positive mBC receives trastuzumab deruxtecan on a clinical trial after experiencing disease progression on multiple lines of therapy (1:02:42)
• Results of a Phase I trial of trastuzumab deruxtecan for patients with advanced HER2-positive breast cancer previously treated with T-DM1 (1:05:20)
• Benefits and risks of trastuzumab deruxtecan for advanced HER2-positive breast cancer (1:06:31)
• Response to trastuzumab deruxtecan in patients with breast cancer and low HER2 expression (1:09:03)
• Other novel agents and approaches under evaluation for HER2-positive breast cancer (1:13:15)

CME information and select publications