Breast cancer is a complex disease with various subtypes, each requiring specific treatment approaches. Two of the more aggressive forms are HER2-positive (HER2+) breast cancer, driven by overexpression of the HER2 protein, and triple-negative breast cancer (TNBC), which lacks estrogen, progesterone and HER2 receptors. Together, HER2+ and TNBC represent about 30% of breast cancer cases and are known for their rapid growth and higher recurrence rates. However, advancements in targeted therapies and immunotherapy have improved outcomes, offering hope for better long-term survival.
 

New therapies and management strategies

HER2+ breast cancer

• Novel HER2-targeted therapies:
  • Trastuzumab deruxtecan (T-DXd, Enhertu®): This antibody-drug conjugate has shown remarkable efficacy in HER2+ metastatic breast cancer, including in patients with brain metastases.
  • Tucatinib (Tukysa®): Often used in combination with trastuzumab and capecitabine, tucatinib has demonstrated improved outcomes in patients with brain metastases.
  • Margetuximab: This Fc-engineered antibody has shown promise in combination with chemotherapy for pretreated HER2+ metastatic breast cancer.
• Advancements in neoadjuvant treatments:
  • Dual HER2 blockade: Combining trastuzumab and pertuzumab in the neoadjuvant setting has significantly increased pathological complete response rates.
  • De-escalation strategies: Exploring reduced chemotherapy for early HER2+ breast cancer.
• Personalized treatment approaches:
  • HER2-low breast cancer: The success of trastuzumab deruxtecan in HER2-low tumors has led to a redefinition of HER2 positivity and new treatment options for this subset of patients.
  • Biomarker-guided therapy: Ongoing research is identifying biomarkers that may predict response to specific HER2-targeted therapies, allowing for more targeted treatment selection.

“With the recent advancements in targeted therapies and personalized treatment strategies, we’re able to offer more effective and less invasive options for patients with aggressive breast cancer subtypes like HER2+ and TNBC. Combining cutting-edge technologies with compassionate care ensures that each patient receives the most tailored approach possible for their condition.”  —Sommer Gunia, DO, breast surgical oncologist, HonorHealth Cancer Care

TNBC

• Immunotherapy breakthroughs:
  • Pembrolizumab (Keytruda®): This PD-1 inhibitor, when combined with chemotherapy, has shown improved progression-free and overall survival in metastatic TNBC patients with PD-L1-positive tumors.
  • Atezolizumab (Tecentriq®): Another immunotherapy option that has demonstrated efficacy in combination with nab-paclitaxel in PD-L1-positive metastatic TNBC.
• PARP inhibitors:
  • Olaparib and talazoparib: These PARP inhibitors have shown significant benefits in BRCA-mutated metastatic TNBC, offering a targeted approach for this subset of patients.
• Antibody-drug conjugates:
  • Sacituzumab govitecan (Trodelvy): This Trop-2-directed antibody drug conjugate has demonstrated improved outcomes in pretreated metastatic TNBC patients.
  • Emerging targets: New antibody-drug conjugates targeting other TNBC-associated antigens are in various stages of clinical development.
• Other emerging strategies:
  • AKT inhibitors: Drugs like ipatasertib have shown promise in combination with paclitaxel for a subset of TNBC patients.
  • Androgen receptor (AR) targeting: AR-positive TNBC may benefit from antiandrogen therapies, offering a new approach for this TNBC subtype.

“Our breast cancer program is dedicated to staying ahead of the curve regarding innovations and technology. We strive to deliver the best care to our patients, whether through targeted therapies or advanced surgical options.”  —Noemi Sigalove, MD, breast surgical oncologist, HonorHealth Cancer Care

The landscape of HER2+ and TNBC treatment is rapidly evolving, offering new hope for patients with these aggressive forms of breast cancer. At HonorHealth, our team of expert breast surgeons is at the forefront of these advancements, providing personalized care to each patient’s unique needs.

For more information about our comprehensive breast cancer program or to refer a patient, please contact 855-485-HOPE (4673) or visit breast cancer care at HonorHealth. Our state-of-the-art cancer care facilities are located valley-wide, ensuring accessible, world-class care for your patients. Please visit HonorHealth Cancer Care locations for more details about locations.