How do you use neratinib in HR+ HER2+ patients in the adjuvant setting if patients got adjuvant T-DM1 for residual disease after neoadjuvant therapy?
Neratinib was studied following adjuvant trastuzumab. Do you extrapolate that data to give neratinib to patients who have received adjuvant T-DM1 instead of trastuzumab?
1 Answer
Mednet MemberInvited Expert
Medical Oncology · David Geffen School of Medicine at UCLA
Answered on
I do not routinely apply neratinib. I base the decision on my best estimate of two factors:
- The obvious issues with neratinib toxicity
- The residual risk that the patient has after TDM1. Not all residual disease patients are equal. I would approach a patient with a minimal response to neoadjuvant th...
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