Would you offer a mid-treatment transition from transtuzumab to TDM-1 for a patient already on 1 year of adjuvant trastuzumab who met criteria for adjuvant TDM-1 based on the KATHERINE trial?

The question is if the patient is er positive or negative. Most patients with residual disease are ER-positive or HER-2 positive. If the patient was ER-positive I would discuss switching vs. neratinib and go through the pros and cons of both.

Yes, it is worth trying to make a switch. We have actually done that in a patient half way.

No particular selection criteria other than if they had residual disease after neoadjuvant therapy. The only question is whether insurance will authorize the switch.

Of course, this is a transient case scenar...