New Therapies for HER2-Positive Metastatic Breast Cancer Show Promise, Although Research on Sequencing is Needed

April 12, 2021

Over the past 18 months, the FDA has approved 4 new regimens for HER2-positive metastatic disease.

In an interview with Pharmacy Times, Kelly Gaertner, PharmD, an oncology clinical pharmacy specialist with Allegheny Health Network, said that a slew of new treatments for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer offer exciting new possibilities for this patient population, although questions remain about optimal sequencing.

Gaertner will be presenting on the topic on Friday at the Hematology/Oncology Pharmacy Association’s virtual 2021 conference.

Prior to December 2019, Gaertner said the standard first-line therapy for HER2-positive metastatic breast cancer was trastuzumab plus pertuzumab and a taxane. Second-line standard therapy involved ado trastuzumab emtansine. Third and subsequent lines of therapy had no standard regimen, however.

Over the past 18 months, the FDA has approved 4 new regimens for HER2-positive metastatic disease, including trastuzumab deruxtecan; neratinib plus capecitabine; tucatinib, capecitabine, and trastuzumab; and the monoclonal antibody margetuximab. Although questions still remain about the optimal sequencing for these treatments in third and subsequent lines of therapy, Gaertner said the approvals are exciting developments.