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SABCS 2022 | The evolution of HER2 targeting in metastatic breast breast cancer

Rupert Bartsch, MD, Comprehensive Cancer Center Vienna, Vienna, discusses the evolution of HER2 targeting in metastatic breast cancer. For many years, treatment with trastuzumab, pertuzumab and chemotherapy has been used in the first-line setting and trastuzumab emtansine in the second-line setting. Based upon the data of the Phase III DESTINY-Breast03 (NCT03529110) trastuzumab emtansine is the new standard in the second-line setting, demonstrating a significant improvement in progression-free survival (PFS). Third-line treatment usually consists of the triple combination of the tyrosine kinase inhibitor (TKI) tucatinib with capecitabine and trastuzumab. However, patients will eventually progress on these treatments, calling for novel treatment strategies in later lines to improve patient outcomes. For patients with brain metastasis, whole brain radiotherapy should be avoided due to late cognitive decline and instead focal radiotherapy, or systemic therapy may be used. However, new treatment options are needed to prevent brain metastasis from occurring in the first place due to the increase in morbidity and mortality rates in patients who develop brain metastasis. This interview took place at the San Antonio Breast Cancer Symposium (SABCS) 2022 in San Antonio, TX.

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