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For a patient with well differentiated de novo triple positive metastatic breast cancer who did not respond to THP, do you sequence all available HER2 targeted options before endocrine therapy?

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Medical Oncology · Sarah Cannon Research Institute

Endocrine combinations for triple positive breast cancer are honestly a bit understudied. We are starting to get more data in this space, SUMMIT, for example, neratinib + fulvestrant + trastuzumab. I think endocrine based combinations are very interesting and there are likely some tumors that are mo...

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty

Triple-positive breast carcinoma (TPBC) is a subset of HR+/HER2+ tumors expressing both ER and PR. To date, only a few published reports have specifically studied TPBC and have focused on clinical outcomes in the adjuvant setting. (Vici et al., PMID 26910921) (You et al., PMID 30607163). In these st...

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Medical Oncology · Private Practice and Digital Health

Whenever I hear well differentiated and HER2-positive in the same sentence, I must question whether this is a true HER2-positive disease.

About 10% of all breast cancers are ER+/HER2+ and half of those are also PR+, so triple-positive tumors account for only 5% of breast cancer.

The vast majority of t...

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Medical Oncology · Mount Sinai Medical Center

I agree with both Dr. @Dr. First Last and Dr. @Dr. First Last. However, this particular triple positive intrinsic subtype has presented itself as not HER2 responsive. Hence making me suspect a more endocrine-dominant biology. NGS and ESR evaluation with Mamaprint/blueprint subtyping albeit data is s...

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Medical Oncology · Icahn School of Medicine at Mount Sinai/Mount Sinai Hospital

Depends on the age, medical comorbidities, and extent of disease

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Medical Oncology · Mayo Clinic Rochester

I think that this is nuanced by grade, potentially Ki-67, repeat biopsy, and receptor testing at progression or surgery, and also patient PS and comorbidities.

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