What are the recommended second-line treatment options for patients with metastatic HER2+ breast cancer who have received frontline trastuzumab deruxtecan (T-DXd)?
Should a taxane-based regimen be considered, or would the HER2CLIMB regimen be more appropriate?
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For a patient with HER2+ metastatic breast cancer who has progressed on frontline T-DXd, what is your preferred second-line approach?
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2 Answers
Mednet MemberInvited Expert
Medical Oncology · University of North Carolina at Chapel Hill
Answered on
There is currently limited direct evidence to guide optimal sequencing after frontline trastuzumab deruxtecan, so second-line treatment decisions are individualized. In many cases, the HER2CLIMB regimen with tucatinib, capecitabine, and trastuzumab is an appealing option, particularly for patients w...
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Mednet MemberInvited Expert
Medical Oncology · Mayo Clinic
Answered on
There are no clinical trial-level data to guide us on this, but in my practice, I would consider going to THP as a second-line if the patient is a good candidate at that point. For patients with CNS metastases progressing on T-DXd, I would likely move on to the HER2CLIMB regimen with capecitabine, t...
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