What are the recommended second-line treatment options for patients with metastatic HER2+ breast cancer who have received frontline trastuzumab deruxtecan (T-DXd)?

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...

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...