By Krystal Redman (KR), DrPH, MHA, (they/she), Executive Director
In the education session entitled HER2+ Breast Cancer: Updates from the Clinic and the Lab, Dr. Sherene Loi, MD, PhD Professor, Peter MacCallum Cancer Centre Melbourne, Victoria, Australia, provided a presentation titled Recent advances in systemic disease.
The session offered updates to the DESTINY Clinical Trials for Metastatic Breast Cancer and discussed advancements in the treatment of HER2+ breast cancer, particularly highlighting the antibody-drug conjugate trastuzumab deruxtecan (T-DXD).
I entered this particular session with the following questions I wanted answered in the forefront of my mind:
In recent years, significant strides have been made in the realm of HER2+ breast cancer treatment, with a particular focus on the groundbreaking drug T-DXD. This innovative therapy has not only gained approval for second-line use and beyond but has also exhibited remarkable efficacy, offering hope for improved outcomes in the challenging landscape of HER2+ breast cancer.
Here’s an explanation of the key points:
Things to note with treatment:
In summary, Dr. Loi emphasizes recent progress in HER2+ breast cancer treatment with T-DXD, highlighting its approval for second-line use and beyond, as well as its “remarkable efficacy.” The focus is now on understanding and overcoming resistance mechanisms to further enhance the clinical benefits of T-DXD for patients with HER2+ breast cancer. While trastuzumab deruxtecan has shown promise, the journey toward conquering HER2+ breast cancer comes with its challenges. One pressing concern is the emergence of resistance to T-DXD in some patients. The clinical community is currently engrossed in deciphering the intricate mechanisms behind this resistance, aiming to unravel the mysteries that hinder the treatment’s effectiveness in certain cases.
As research progresses and the clinical community navigates the complexities of resistance, the future holds the promise of improved outcomes and prolonged survival for those diagnosed with HER2+ breast cancer. The preceding statement suggests that there is a current urgency or opportune moment to conduct more clinical trials that are driven and reported based on biomarkers. Biomarkers are measurable indicators that can provide information about a biological state or condition. In the context of cancer research, these biomarkers can help identify specific characteristics of tumors or patients that may influence treatment outcomes.
In summary, there is a need for more clinical trials that are tailored to specific biomarkers, indicating a shift toward a more personalized and targeted approach in cancer research. By focusing on these specific criteria, researchers aim to better understand the nuances of treatment response and outcomes based on the molecular and clinical characteristics of the patients and their tumors.
I began the session with the questions: “Are the presented treatment(s) and therapies less toxic than other currently available options? And will they improve quality of life and extend overall survival?” on my mind, and those questions remain.
According to Dr. Loi, science is working to “look at treatment combinations with less adverse effects.” She states that providers “really need to stop just ADDING on new immunotherapy agents (with overlapping toxicity) to older AC-T (doxorubicin + cyclophosphamide, followed by paclitaxel) combinations.”
Yes, I appreciate that Dr. Loi is calling on providers to think about adverse effects and quality of life when discussing treatment combinations. Dr. Loi was clear and further stated that, in moving forward with immunotherapies, patients need trials:
Overall, the main message in this session is the importance of using treatment combinations that are not only efficacious but also have fewer adverse effects.