Breast Cancer Specialist Says Guidelines for HER2 Cancer Subtypes Can Optimize Patient Treatment

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Guidelines for HER2-low expressed cancer could define who and how patient recieve drugs, said expert live from San Antonio Breast Cancer Symposium 2022.

Adam Brufsky, MD, PhD, a professor of medicine at the University of Pittsburg’s School of Medicine and Co-Director of the Comprehensive Breast Cancer Center, also explains to Pharmacy Times about the importance of the pharmacist as part of the cancer patient’s care team, especially with early detection of adverse events from treatment.

PT Staff:What should pharmacists know about HER2-low breast cancer?

Adam Brufsky, MD, PhD: Pharmacists need to know about HER2-low because they will be the ones helping administer the drugs. And I think, again, these are typical drugs and payload is aromatique and derivative. So in this case, it’s a deruxtecan. And it has very similar side effects except for the interstitial lung disease (ILT). And I think that, you know, they need an awareness of ILT, I think it's the biggest thing about these drugs.

PT Staff: How can pharmacists help patients with HER2-low breast cancers address adverse events from treatment to improve general outcomes?

Adam Brufsky, MD, PhD: So I think a general awareness of interstitial lung disease (ILT) is important. And it's important that the patients get reinforced from multiple sources. So the nurses in the treatment group will [say] to them that, if you have cough, or shortness of breath is worse than anything you've had before….dry cough or shortness of breath, you need to let someone know early, because early recognition is important.

So the nurse will do that, the physicians will do that, the nurse practitioners will do that. The physicians’ assistants will do that. And if the pharmacist do that as well, we can all work as a team to reinforce that early detection of this 1 in 10 event is important—it is important for people to kind of know.

PT Staff: Does outlining new guidelines to distinguish between HER2 cancers impact patient treatment options?

Adam Brufsky, MD, PhD: Yes. I think if we have guidelines for the treatment of HER2 overexpressed cancer, I think we're going to have guidelines for treatment of HER2-low express cancer. And I think we need to do a good job of figuring out who is HER2 0 versus 0-1+ or 2+. I think, hopefully, there'll be agreement on what constitutes HER2 1+, with pathologist with managed care with other payers with physicians. I think if all stakeholders agree that we have a definition of who should be receiving these drugs, I think patient outcomes can be optimized, yes.

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