Managing Advanced HER2+ Breast Cancer: Expert and Patient Perspectives

Panelists provide a brief overview of breast cancer, discussing typical presentations of advanced breast cancer; key risk factors such as age, gender, and family history; various subtypes of the disease; and the essential steps in diagnosing, risk assessing, and staging patients.

Panelists discuss how a patient navigated her recurrent breast cancer diagnosis, detailing the symptoms, referral process, diagnostic tests, treatment considerations, and the concerns faced throughout the journey, while also examining the steps taken to confirm her HER2+ diagnosis.

Panelists discuss how effective care coordination at Memorial Sloan Kettering (MSK) involves a multidisciplinary team of health care professionals working collaboratively to optimize the patient’s journey from diagnosis through treatment and follow-up, highlighting the essential role of nurse practitioners in this process.

Panelists discuss how a patient experienced care coordination during treatment at Memorial Sloan Kettering (MSK), detailing the health care professionals involved, the integration of services such as wound care and integrative medicine, and the positive impact of a team-based approach on her treatment experience and confidence in her care.

Panelists discuss how education and resources are provided to patients with breast cancer upon diagnosis, highlighting the importance of tailoring educational approaches to individual needs and preferences, and they also explore the various courses, books, and resources that patients have found helpful in their self-education journey.

Panelists discuss how a patient navigated her treatment journey at Memorial Sloan Kettering (MSK), detailing the specific treatments received, her responses to those treatments, and her active participation in the shared decision-making process regarding her care.

Panelists discuss a high-level overview of systemic therapies for advanced HER2+ breast cancer, outlining the roles of HER2-targeted monoclonal antibodies, tyrosine kinase inhibitors (TKIs), and antibody-drug conjugates (ADCs) in treatment, as well as treatment strategies for patients with brain metastases. They also explore the shared decision-making process that informed the recommendation of the HER2CLIMB regimen.

Panelists discuss key data from the HER2CLIMB study, which evaluates the efficacy of tucatinib (Tukysa) in combination with trastuzumab (Herceptin) and capecitabine (Xeloda) for patients with advanced HER2+ breast cancer, highlighting outcomes across patient subgroups and the clinical significance of findings related to patients with measurable baseline intracranial disease.

Panelists discuss a brief overview of recent data on combination systemic therapies for the treatment of advanced HER2+ breast cancer, including studies such as DESTINY-Breast03, DEBBRAH, HER2CLIMB-02, and EMILIA, and they analyze which patient populations may benefit most from each therapy option based on the available data.

Panelists discuss the progress of the BRIDGET trial and its potential impact on HER2-positive breast cancer patients, focusing on the anticipated data and its implications for treatment strategies in this population.

Panelists discuss how patients are prepared for treatment, the adverse effects associated with different agents and combination regimens that they educate patients about, the process of administering treatment for HER2+ breast cancer, and the overall approach to monitoring and managing adverse effects throughout the treatment journey.

Panelists discuss the adverse effects experienced by a patient undergoing treatment with capecitabine (Xeloda), trastuzumab (Herceptin), and tucatinib (Tukysa), along with the strategies employed to manage those adverse effects, while also addressing patient follow-up procedures, including the frequency of visits, typical labs and imaging ordered, concerning symptoms and lab results, and the outcomes of the patient's most recent follow-up appointment.

Panelists discuss the supportive care considerations for patients being treated for metastatic HER2+ breast cancer, including the roles of nutrition, exercise, and other integrative approaches in enhancing patient well-being and treatment outcomes.

Panelists discuss key aspects of supportive care that aided a patient's journey, including the impact of her primary caregiver's support, the sources of strength drawn from personal, spiritual, or community connections, and the roles of integrative medicine and nutrition in her treatment experience.

Panelists discuss emerging regimens and agents being explored for the future treatment of advanced HER2+ breast cancer, highlighting the potential innovations that may improve patient outcomes.

Panelists discuss advice for nurses collaborating with oncologists in treating patients with HER2+ breast cancer, as well as closing messages for patients receiving treatment and clinicians involved in the care of those with advanced HER2+ breast cancer.

In a From All Angles program, a patient and her treating physician spoke about the initial diagnosis, care coordination, communication, and the adverse effects observed.