Would you use T-DXd or capecitabine/trastuzumab/tucatinib for HER2+ metastatic breast cancer with predominantly CNS progression after THP?

Topics: Breast Cancer • Medical Oncology • Her2+ • CNS Disease • Journal Club ft. NEJM publications • Breast Cancer, Metastatic

Which regimen is preferred in second line for these patients? What is the efficacy of TDXd vs tucatinib in CNS metastases?

Answer from: Medical Oncologist at Academic Institution

For now, my preference is based on the HER2CLIMB trial that was specifically designed to assess outcomes of patients with brain metastases, including untreated asymptomatic or mildly symptomatic brain metastases and showed a survival benefit in the overall population as well as the patients with bra...

Comments

Medical Oncologist at Cancer Care Specialists/Renown Oncology/UNR
ESMO Breast update of TUXEDO shows ORR 73.3% in 14...

Answer from: Medical Oncologist at Academic Institution

Clinical trials with T-DXd and capecitabine/tucatinib/trastuzumab have included patients with brain metastases and have reported on intracranial responses in patients with brain metastases. It is important to note that measuring brain metastases can be difficult and there is some variability in resp...

Answer from: Medical Oncologist at Community Practice

For patients who have received Trastuzumab and Pertuzumab-based therapy and experience brain progression, we have different options. These patients were excluded in both DESTINY-BREAST03 and HER2CLIMB trials. In the first case because patients with unstable metastasis were not allowed to be included...

Related Questions