We know that a “triple-negative” breast cancer diagnosis is a tough one. Not as many specific treatment options are available. However, for those diagnosed with estrogen-positive, progesterone-positive, and/or human epidermal growth factor receptor 2 (HER2)-positive breast cancer, the options are growing, with promise for more to come in the near and distant future.
Just this past April, the Journal of Clinical Oncology published an interesting study about the positive effects of using a dual effort in targeting the human epidermal growth factor receptor 2 (HER2) in HER2-positive breast cancer patients that resulted in a pathologic complete remission (pCR) in 27 percent of patients. Wow! Using a combination of targeted therapy to avoid systemic chemotherapy, this could revolutionize how we treat breast cancer in the future.
The study included a couple of different combinations of HER2-targeted treatments, which were administered preoperatively in Stage II-III HER2-positive breast cancer patients. One study included the combination of pertuzumab (Perjeta) and trastuzumab (Herceptin). Another study combined lapatinib (Tykerb) and trastuzumab (Herceptin). In the latter study, the overall in-breast pCR was 27 percent after 12 weeks of combined treatment.
These findings show promise for effective strategy for increasing tumor shrinkage compared to a single-agent HER2 therapy with or without systemic chemotherapy. It leads to the possibility of clinicians to be able to one day identify which appropriate patients can avoid systemic chemotherapy altogether. Currently, combining systemic chemotherapy with anti-HER2 therapy is the standard approach for the majority of HER2-psotitive breast cancer patients. But maybe, that will not be the norm in years to come.
Have you heard of using dual anti-HER2 therapy at your facility? If so, what had been the discussion and interventions taken thus far?
If you were diagnosed with HER2-positive breast cancer, would you feel comfortable receiving a targeted therapy without chemotherapy?