MIAMI BEACH – Unquestionably, the advent of human epidermal growth factor receptor-2 (HER2) inhibitors has dramatically improved long-term outcomes in patients with HER2-positive breast cancer.
But the benefits of therapy with the HER2-inhibitor trastuzumab (Herceptin) must be weighed against its potential for causing or exacerbating cardiomyopathy, especially when combined with anthracyclines such as doxorubicin that are associated with increased risk for late cardiotoxicity, said Sara Hurvitz, MD, director of the Breast Cancer Clinical Research Program at the David Geffen School of Medicine at UCLA in Santa Monica, Calif.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel.
Many patients with HER2-positive disease can be safely and effectively treated with local therapy alone, but clinicians at present have no reliable way of knowing which patients are likely to have excellent outcomes without adjuvant systemic therapies or which are at high risk for recurrence and might benefit from HER2 with or without an anthracycline, leading to overtreatment of some patients out of an abundance of caution, she said at the annual Miami Breast Cancer Conference, held by Physicians’ Education Resource.
In a video interview, Dr. Hurvitz discussed strategies under development for identifying and evaluating biomarkers and cardiac imaging studies that could help to identify patients at highest risk for long-term cardiotoxicity, as well as alternative therapeutic regimens that eliminate the need for anthracyclines.
Dr. Hurvitz disclosed grants/research support from Amgen, Bayer, Boehringer Ingelheim, Genentech, GlaxoSmithKline, Pfizer, Roche, Biomarin, Merrimack, OBI Pharma, Puma Biotechnology, Dignitana, Medivation, Lilly and Novartis, and travel reimbursement from Lilly, Novartis, and OBI Pharma.