Mark D. Pegram, MD

Mark Pegram, MD, spoke the most important data from the IDEAL trial he believes his colleagues should take away.

Mark Pegram, MD, discussed the highlights from ASCO 2022, regarding antibody drug conjugates.

Mark Pegram, MD, spoke about predictive and prognostic factors used to determine which patients with early-stage hormone receptor–positive breast cancer benefit from extended vs standard adjuvant endocrine therapy.

Mark Pegram, MD, spoke about using the Breast Cancer Index and Clinical Treatment Score post-5 years to determine outcomes for patients with early-stage hormone receptor–positive breast cancer treated with adjuvant endocrine therapy.

Experts discussed the changing landscape in treatments for HER2-positive metastatic breast cancer.

Experts close out their discussion on the management of HER2+ metastatic breast cancer by highlighting their hopes for future treatment strategies.

Centering their conversation on a patient case, experts discuss the sequencing and monitoring of therapy in patients with HER2+ metastatic breast cancer.

Panelists field questions from a live audience regarding the optimal selection of therapy for patients with metastatic breast cancer.

In another patient case, panelists break down third-line therapy options for someone with HER2+ metastatic breast cancer and lung disease.

Moving to optimal treatment approaches in second-line therapy, experts close out a patient case of HER2+ metastatic breast cancer.

Using a patient case to center their discussion, the panel reviews frontline treatment options for HER2+ metastatic breast cancer and the rationale behind selection.

Fielding questions from a live audience, experts discuss the lack of biomarkers in HER2+ metastatic breast cancer and how one might address progression of bone disease.

A panel of experts reviews clinical trial data in recurrent HER2-positive metastatic breast cancer and discusses impacts on treatment selection.

Panelists provide an overview of the treatment landscape for patients with HER2-positive metastatic breast cancer.

The preferred status of CLEOPATRA-like regimens in the first-line HER2-positive metastatic breast cancer setting has recently been challenged by antibody-drug conjugate regimens based on ado-trastuzumab emtansine (T-DM1).

As part of our coverage for the 30th Annual Miami Breast Cancer Conference, we bring you an interview with Dr. Mark Pegram, director of the breast cancer program at the Stanford Women’s Cancer Center and codirector of the molecular therapeutics program. Dr. Pegram will be discussing the potential for novel HER2 combination therapies at the conference.

In this issue of ONCOLOGY, Drs. Lim and Lin present a comprehensive and up-to-date review of the basic biology of breast cancer brain metastasis (BCBM) and of emerging strategies for treating this increasingly common complication of advanced breast cancer (BC) (BC is second only to non–small-cell lung cancer in the frequency of central nervous system [CNS] metastasis.)

Trastuzumab (Herceptin) is an effective treatment in patients withHER2-overexpressing metastatic breast cancer. Risk of trastuzumabinducedcardiotoxicity raises concerns regarding combined use withanthracyclines or other potentially cardiotoxic agents followinganthracycline treatment. We characterized interactions betweentrastuzumab and gemcitabine (Gemzar) and the combination ofgemcitabine and cisplatin or carboplatin (Paraplatin) as such combinationsmight help reduce the risk of cardiotoxicity. Multiple drugeffect/combination index isobologram analysis was used to study theefficacy of chemotherapeutic drug plus trastuzumab combinations inHER2-overexpressing breast cancer cell lines. Combination index valueswere derived from parameters of the median effect plots, and statisticaltests were used to determine whether the mean combinationindex at multiple effect levels significantly differed from a combinationindex value of 1.0 (values < 1.0 indicate synergy; values > 1.0,antagonism; values equal to 1.0, additivity). At a wide range of clinicallyachievable drug concentrations, interactions between trastuzumaband gemcitabine were synergistic at low concentrations of gemcitabineand antagonistic at high concentrations. A consistent synergistic interactionwas observed with the three-drug combination of trastuzumabplus gemcitabine plus carboplatin or cisplatin. Available clinical dataon the use of trastuzumab plus gemcitabine, and trastuzumab plusgemcitabine/paclitaxel, as well as clinical data on the use ofgemcitabine/cisplatin in breast cancer, are discussed. These findingsindicate that trastuzumab plus gemcitabine and trastuzumab plusgemcitabine plus cisplatin or carboplatin are rational combinations toevaluate in clinical trials.