Opinion|Videos|November 25, 2024

Navigating Systemic Therapy Options in HER2+ Breast Cancer

Author(s)Neil M. Iyengar, MD, Odessa Williams, NP, ANCC, Dorian Nygard

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.

Episodes in this series

EP. 1 Overview of HER2 Breast Cancer

EP. 1 Overview of HER2 Breast Cancer

EP. 2 HER2+ Breast Cancer Diagnosis: Insights From Patients and Clinicians

EP. 2 HER2+ Breast Cancer Diagnosis: Insights From Patients and Clinicians

EP. 3 Coordinating Care for HER+ Breast Cancer Patients: A Multidisciplinary Approach

EP. 3 Coordinating Care for HER+ Breast Cancer Patients: A Multidisciplinary Approach

EP. 4 Multidisciplinary Care of HER2+ Breast Cancer: A Patient Perspective

EP. 4 Multidisciplinary Care of HER2+ Breast Cancer: A Patient Perspective

EP. 5 Tailoring Patient Education and Resources in HER2+ Breast Cancer

EP. 5 Tailoring Patient Education and Resources in HER2+ Breast Cancer

EP. 6 Navigating HER2+ Breast Cancer Treatment: A Patient's Journey

EP. 6 Navigating HER2+ Breast Cancer Treatment: A Patient's Journey

EP. 7 Navigating Systemic Therapy Options in HER2+ Breast Cancer

EP. 7 Navigating Systemic Therapy Options in HER2+ Breast Cancer

EP. 8 Key Insights from the HER2CLIMB Trial

EP. 8 Key Insights from the HER2CLIMB Trial

EP. 9 Key Insights From the DEBBRAH and HER2CLIMB-02 Studies

EP. 9 Key Insights From the DEBBRAH and HER2CLIMB-02 Studies

EP. 10 BRIDGET Trial: Strategies in Maintenance Therapy for HER2+ Breast Cancer with Brain Metastases

EP. 10 BRIDGET Trial: Strategies in Maintenance Therapy for HER2+ Breast Cancer with Brain Metastases

EP. 11 Preparing Patients for Treatment: Education, Administration and Adverse Effect Management in HER2+ Breast Cancer

EP. 11 Preparing Patients for Treatment: Education, Administration and Adverse Effect Management in HER2+ Breast Cancer

EP. 12 Patient Perspectives on Managing Adverse Effects from Capecitabine, Trastuzumab, and Tucatinib

EP. 12 Patient Perspectives on Managing Adverse Effects from Capecitabine, Trastuzumab, and Tucatinib

EP. 13 Comprehensive Supportive Care for Metastatic HER2+ Breast Cancer

EP. 13 Comprehensive Supportive Care for Metastatic HER2+ Breast Cancer

EP. 14 Patient Perspective: Key Aspects of Supportive Care in the HER2+ Breast Cancer Journey

EP. 14 Patient Perspective: Key Aspects of Supportive Care in the HER2+ Breast Cancer Journey

EP. 15 Future Perspectives in HER2+ Breast Cancer

EP. 15 Future Perspectives in HER2+ Breast Cancer

EP. 16 Closing Thoughts: Key Messages for Clinicians and Patients in the Treatment of HER2+ Breast Cancer

EP. 16 Closing Thoughts: Key Messages for Clinicians and Patients in the Treatment of HER2+ Breast Cancer

EP. 17 Discussing, Managing, and Treating HER2+ Breast Cancer From the Patient’s Perspective

EP. 17 Discussing, Managing, and Treating HER2+ Breast Cancer From the Patient’s Perspective

Dr Iyengar: Please provide a high-level overview of the systemic therapies that you consider for advanced HER2+ breast cancer. (sSee NCCN Guidelines Version 2.2024.)
1. What is the role of HER2-targeted monoclonal antibodies, tyrosine kinase inhibitors (TKIs), and ADCs in treating advanced HER2+ breast cancer?
2. How do you typically manage treat patients with advanced HER2+ breast cancer and brain metastases?
3. Following Dorian’s evaluation, how did the shared decision-making process unfold, and what factors ultimately led you to recommend the HER2CLIMB regimen (trastuzumab [Herceptin] and + tucatinib [Tukysa] and capecitabine [Xeloda])?

Newsletter

Stay up to date on recent advances in the multidisciplinary approach to cancer.

Related Content

Latest CME

Navigating Treatment Gaps in SCLC: Relapse, Resistance, and Need for New Options

Navigating Treatment Gaps in SCLC: Relapse, Resistance, and Need for New Options

Rahul Gosain, MD, MBA; Rohit Gosain, MD; Giannis Mountzios ΜD, PhD

Medical Crossfire® in Adjunctive Testing: Charting a New Course in Prostate Cancer Risk Assessment

Medical Crossfire® in Adjunctive Testing: Charting a New Course in Prostate Cancer Risk Assessment

Jason Hafron, MD; Aaron D. Berger, MD; Arpeet Shah, MD

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Arkansas Association of Cancer Professionals

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Arkansas Association of Cancer Professionals

Kamel Abou Hussein, MD; Yelda Nouri, MD

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Rhode Island Oncology Society

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Rhode Island Oncology Society

Aditya Bardia, MD, MPH, FASCO; Benjamin Scheier, MD

Radioligand Therapy 101: The Science Behind the Strategy

Radioligand Therapy 101: The Science Behind the Strategy

Jeremie Calais, MD, PhD; Tanya B. Dorff, MD; Scott T. Tagawa, MD, MS, FACP, FASCO

Imaging Matters: Decoding PSMA PET for Better Decision-Making

Imaging Matters: Decoding PSMA PET for Better Decision-Making

Jeremie Calais, MD, PhD; Tanya B. Dorff, MD; Scott T. Tagawa, MD, MS, FACP, FASCO

BURST CME™ Resource Center: Integrating Novel PSMA-Directed Radioligand Approaches for Diagnosis and Management of Prostate Cancer

BURST CME™ Resource Center: Integrating Novel PSMA-Directed Radioligand Approaches for Diagnosis and Management of Prostate Cancer

Jeremie Calais, MD, PhD; Tanya B. Dorff, MD; Nerina McDonald, MSPAS, PA-C; Scott T. Tagawa, MD, MS, FACP, FASCO

Ready for Radioligand Therapy? Patient Selection and Sequencing Simplified

Ready for Radioligand Therapy? Patient Selection and Sequencing Simplified

Jeremie Calais, MD, PhD; Tanya B. Dorff, MD; Scott T. Tagawa, MD, MS, FACP, FASCO

Medical Crossfire®: ADCs and Bispecifics in Lung Cancer – Hype, Hope, or a New Standard of Care?

In-Person + Virtual Event

Medical Crossfire®: ADCs and Bispecifics in Lung Cancer – Hype, Hope, or a New Standard of Care?

September 12, 2026

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Iowa Oncology Society

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Iowa Oncology Society

Aditya Bardia, MD, MPH, FASCO; Priya Kumar, MBBS, MS

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Empire State Hematology & Oncology Society

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Empire State Hematology & Oncology Society

Aditya Bardia, MD, MPH, FASCO; Mohammad F. Ali, MD

𝘔𝘌𝘛 Alterations in NSCLC: Applying Diagnostic Advances and Targeted Therapies in a New Era of Treatment

𝘔𝘌𝘛 Alterations in NSCLC: Applying Diagnostic Advances and Targeted Therapies in a New Era of Treatment

Jonathan Goldman, MD; Sanja Dacic, MD, PhD; Deborah Doroshow, MD, PhD; Anne S. Tsao, MD, MBA

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | South Carolina Oncology Society

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | South Carolina Oncology Society

Kamel Abou Hussein, MD; Kate Baxstrom, MD

Community Oncology Connections™: Advancing Precision Testing and HER2-Targeted Care for Gastroesophageal Adenocarcinoma – Minnesota

Community Oncology Connections™: Advancing Precision Testing and HER2-Targeted Care for Gastroesophageal Adenocarcinoma – Minnesota

Geoffrey Ku, MD; Jack W. Erter III, MD, MMHC

Community Oncology Connections™: How Can We Optimize the Use of Oral SERDs in the Community Oncology Setting? Best Practices for HR+/HER2– Breast Cancer | Texas Society of Clinical Oncology

Community Oncology Connections™: How Can We Optimize the Use of Oral SERDs in the Community Oncology Setting? Best Practices for HR+/HER2– Breast Cancer | Texas Society of Clinical Oncology

Ajit K. Bisen, MD, MBA; Virginia Kaklamani, MD, DSc

Community Oncology Connections™: Advancing Precision Testing and HER2-Targeted Care for Gastroesophageal Adenocarcinoma – West Virginia

Community Oncology Connections™: Advancing Precision Testing and HER2-Targeted Care for Gastroesophageal Adenocarcinoma – West Virginia

Sunnie S. Kim, MD; Kellie D. Spector, MD

Community Oncology Connections™: Advancing Precision Testing and HER2-Targeted Care for Gastroesophageal Adenocarcinoma – North Carolina

Community Oncology Connections™: Advancing Precision Testing and HER2-Targeted Care for Gastroesophageal Adenocarcinoma – North Carolina

Syma Iqbal, MD; Benjamin Scheier, MD

Community Oncology Connections™: Bridging Academic and Community Connections to Advance Precision and Targeted Care in NF1 Plexiform Neurofibromas | Nevada Oncology Society

Community Oncology Connections™: Bridging Academic and Community Connections to Advance Precision and Targeted Care in NF1 Plexiform Neurofibromas | Nevada Oncology Society

Amy E. Armstrong, MD; Phioanh “Leia” Nghiemphu, MD

Kansas Society of Clinical Oncology

Kansas Society of Clinical Oncology

1 Session is Available!

Satellite Symposia at the Annual Radiation Oncology Meeting

In-Person + Virtual Event

Satellite Symposia at the Annual Radiation Oncology Meeting

September 26-28, 2026

Community Oncology Connections™: Bridging Academic and Community Connections to Advance Precision and Targeted Care in NF1 Plexiform Neurofibromas | Rhode Island Oncology Society

Community Oncology Connections™: Bridging Academic and Community Connections to Advance Precision and Targeted Care in NF1 Plexiform Neurofibromas | Rhode Island Oncology Society

Daniela A. Bota, MD, PhD; Kurt C. Demel, MD, MBA

27th Annual International Lung Cancer Congress®

27th Annual International Lung Cancer Congress®

Roy S. Herbst, MD, PhD; Sandip Patel, MD, FASCO; Heather A. Wakelee, MD, FASCO

Advances in Managing EGFR-Mutant NSCLC: Applying Evidence Across the Disease Continuum

Advances in Managing EGFR-Mutant NSCLC: Applying Evidence Across the Disease Continuum

Tina Cascone, MD, PhD; Christina Baik, MD, MPH; David Planchard, MD, PhD

Community Practice Connections™: Enhancing Melanoma Outcomes With Intratumoral Oncolytic Immunotherapy–Strategies for the Multidisciplinary Team

Community Practice Connections™: Enhancing Melanoma Outcomes With Intratumoral Oncolytic Immunotherapy–Strategies for the Multidisciplinary Team

Yana G. Najjar, MD; Sapna Patel, MD

Community Oncology Connections™: How Can We Optimize the Use of Oral SERDs in the Community Oncology Setting? Best Practices for HR+/HER2– Breast Cancer | Tennessee Oncology Practice Society

Community Oncology Connections™: How Can We Optimize the Use of Oral SERDs in the Community Oncology Setting? Best Practices for HR+/HER2– Breast Cancer | Tennessee Oncology Practice Society

Virginia Kaklamani, MD, DSc; Denise Yardley, MD, GCRA

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Washington State Medical Oncology Society

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Washington State Medical Oncology Society

Kamel Abou Hussein, MD; Yan Ji, MD, PhD

North Carolina Oncology Association

North Carolina Oncology Association

2 Sessions are Available!

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Colorado Oncology Society

Community Oncology Connections™: Monotherapies vs Combinations – Navigating Oral SERDs and Targeted Combination Strategies in HR+/HER2- Metastatic Breast Cancer | Colorado Oncology Society

Kamel Abou Hussein, MD; Kit Y Lu, MD

Community Oncology Connections™: Bridging Academic and Community Connections to Advance Precision and Targeted Care in NF1 Plexiform Neurofibromas | Wisconsin Association of Hematology and Oncology

Community Oncology Connections™: Bridging Academic and Community Connections to Advance Precision and Targeted Care in NF1 Plexiform Neurofibromas | Wisconsin Association of Hematology and Oncology

Daniela A. Bota, MD, PhD; Benjamin Scheier, MD

Community Oncology Connections™: Advancing Precision Testing and HER2-Targeted Care for Gastroesophageal Adenocarcinoma – Montana/Wyoming

Community Oncology Connections™: Advancing Precision Testing and HER2-Targeted Care for Gastroesophageal Adenocarcinoma – Montana/Wyoming

Syma Iqbal, MD; Shiven B. Patel, MD, MBA, FACP

Tennessee Oncology Practice Society

Tennessee Oncology Practice Society

2 Sessions are Available!

Navigating Advances in Neovascular Retinal Disease: Translating Evidence to Practice in AMD, DME, and RVO

Navigating Advances in Neovascular Retinal Disease: Translating Evidence to Practice in AMD, DME, and RVO

SriniVas R. Sadda, MD, FARVO; Mark R. Barakat, MD, FASRS; David A. Eichenbaum, MD, FASRS

Washington State Medical Oncology Society

Washington State Medical Oncology Society

2 Sessions are Available!

Enhancing Prostate Cancer Outcomes – The Role of PSMA and Targeted Treatment Strategies

Enhancing Prostate Cancer Outcomes – The Role of PSMA and Targeted Treatment Strategies

Ana Kiess, MD, PhD; Erin Grady, MD, CCD, FACNM, FSNMMI; Himanshu Nagar, MD, MS; Scott T. Tagawa, MD, MS, FASCO, FACP

Missouri Oncology Society

Missouri Oncology Society

2 Sessions are Available!

New Mexico Society of Clinical Oncology

New Mexico Society of Clinical Oncology

3 Sessions are Available!

9th Annual School of Nursing Oncology™

9th Annual School of Nursing Oncology™

Beth Faiman, PhD, MSN, APN-BC, BMTCN, AOCN, FAAN, FAPO; Beth Sandy, MSN, CRNP, FAPO; Lindsay Adkins, MSN, FNP-BC, BMTCN; Jeneth Aquino, DNP, FNP-BC; Casey Gormley, MSN, FNP-C, AOCNP; Heather J. Jackson, PhD, FNP-BC; Kelsey Martin, AG-ACNP-BC, AOCNP; Nerina T. McDonald, PA-C; Lauren Verity Moore, DNP, MSN, AGACNP-BC; Faith A. Mutale, DNP, CRNP; Tiffany Richards, PhD, ANP-BC, AOCNP; Emily Skotte, DNP, MSN, ACNP-BC; Leslie Smith, DNP, RN, APRN-CNS, AOCNS, BMTCN; Saneese Stephen, PA-C, MPAS; Sara M. Tinsley-Vance, PhD, APRN, AOCN

Personalized Approaches in NSCLC: Early Detection, Molecular Testing, and Targeted Therapies

Personalized Approaches in NSCLC: Early Detection, Molecular Testing, and Targeted Therapies

Charu Aggarwal, MD, MPH, FASCO; Zofia Piotrowska, MD, MHS

Community Practice Connections™: DLL3-Targeting Bispecific Antibodies for Small Cell Lung Cancer—From Innovation to Practice

Community Practice Connections™: DLL3-Targeting Bispecific Antibodies for Small Cell Lung Cancer—From Innovation to Practice

Jacob Sands, MD; Anne Chiang, MD, PhD

Biomarker Testing in HER2+ GEA: Diagnosis and Treatment Implications

Biomarker Testing in HER2+ GEA: Diagnosis and Treatment Implications

Rahul Gosain, MD, MBA; Rohit Gosain, MD; Rutika Mehta, MD, MPH

Navigating the Adverse Event Landscape in HER2+ GEA Therapy

Navigating the Adverse Event Landscape in HER2+ GEA Therapy

Rahul Gosain, MD, MBA; Rohit Gosain, MD; Geoffery Ku, MD; Shruti Patel, MD

Hot Seat: Converging Lines in the Management of RAS-Altered Cancers

Hot Seat: Converging Lines in the Management of RAS-Altered Cancers

Shubham Pant, MD, MBBS; Alison Schram, MD; Helena Yu, MD

(CME Track) Tackling Oncologic Emergencies in Patients Treated With High-Dose Methotrexate

(CME Track) Tackling Oncologic Emergencies in Patients Treated With High-Dose Methotrexate

Shazia Nakhoda, MD; Shruti Gupta, MD, MPH; Anitha Varghese, MSN, APRN, AGPCNP-C

Diagnosis and Management of TGCT

Diagnosis and Management of TGCT

Mark Agulnik, MD; Lee M. Zuckerman, MD

Optimizing Multidisciplinary Care in TGCT

Optimizing Multidisciplinary Care in TGCT

Mark Agulnik, MD; Lee M. Zuckerman, MD

Revolutionizing TGCT Care with Multidisciplinary Perspectives and Cutting-Edge Targeted Therapies

Revolutionizing TGCT Care with Multidisciplinary Perspectives and Cutting-Edge Targeted Therapies

Mark Agulnik, MD; Lee M. Zuckerman, MD

Cases & Conversations™: Unmasking Epithelioid Sarcoma – Enhancing Early Diagnosis and Multidisciplinary Care

Cases & Conversations™: Unmasking Epithelioid Sarcoma – Enhancing Early Diagnosis and Multidisciplinary Care

Mark Agulnik, MD; Mrinal M. Gounder, MD; Sandra D’Angelo, MD; Sujana Movva, MD

The Rise of Novel HER2-Targeting Therapies in GEA: Mechanisms and Clinical Data

The Rise of Novel HER2-Targeting Therapies in GEA: Mechanisms and Clinical Data

Rahul Gosain, MD, MBA; Rohit Gosain, MD

Show Me the Data™: Personalizing First-Line and Maintenance Therapy in HER2+ Metastatic Breast Cancer to Extend Survival and Elevate Quality of Life

Show Me the Data™: Personalizing First-Line and Maintenance Therapy in HER2+ Metastatic Breast Cancer to Extend Survival and Elevate Quality of Life

Sara A. Hurvitz, MD, FACP; Rena Callahan, MD; Michelle Melisko, MD; Paolo Tarantino, MD, PhD

Beyond Primary End Points: Digging Into Randomized and Real-World Data to Guide Challenging Treatment Decisions in HR+/HER2− Metastatic Breast Cancer

Beyond Primary End Points: Digging Into Randomized and Real-World Data to Guide Challenging Treatment Decisions in HR+/HER2− Metastatic Breast Cancer

Seth A. Wander, MD, PhD; Marla D. Lipsyc-Sharf, MD

Real-World Insights on Advances in the Management of Myeloproliferative Neoplasms: How the Experts Apply the Latest Developments to Clinical Practice

Real-World Insights on Advances in the Management of Myeloproliferative Neoplasms: How the Experts Apply the Latest Developments to Clinical Practice

Naveen Pemmaraju, MD; Shannon Elf, PhD; Angela Fleischman, MD, PhD; Bethan Psaila, MD

Tumor Board™: Navigating a New Era of Innovation and Expanding Options in NMIBC

Tumor Board™: Navigating a New Era of Innovation and Expanding Options in NMIBC

Archan Khandekar, MD; Wassim Kassouf, MD, CM, FRCSC; Jen-Jane Liu, MD

“D” is for Diagnosis: Decoding a Difficult Thoracic Malignancy—Piecing Together a Rare Diagnosis, Preparing for Tomorrow’s Treatments

“D” is for Diagnosis: Decoding a Difficult Thoracic Malignancy—Piecing Together a Rare Diagnosis, Preparing for Tomorrow’s Treatments

Aakash Desai, MD, MPH; Ibiayi Dagogo-Jack, MD, FASCO; Patrick Forde, MD, PhD

Combination Approaches in PD-L1–Positive mTNBC: Practice-Changing Frontline Evidence

Combination Approaches in PD-L1–Positive mTNBC: Practice-Changing Frontline Evidence

Rahul Gosain, MD, MBA; Rohit Gosain, MD; Sherene Loi, MMBS (Hons), FRACP, PhD, FAHMS

First-Line ADC Monotherapy in mTNBC: Addressing Unmet Needs in Immunotherapy-Ineligible Populations

First-Line ADC Monotherapy in mTNBC: Addressing Unmet Needs in Immunotherapy-Ineligible Populations

Rahul Gosain, MD, MBA; Rohit Gosain, MD; Adam Brufsky, MD, PhD

(CPE Track) Antibody–Drug Conjugates in Oncology: The Essentials of AE Management for Better Patient Outcomes

(CPE Track) Antibody–Drug Conjugates in Oncology: The Essentials of AE Management for Better Patient Outcomes

Michelle L. Taylor, ANP-BC; Emely Alfaro, DNP, RN, CNS, OCN; Paige Griffith, CRNP; Beth Sandy, MSN, CRNP, FAPO

Trending on CancerNetwork

FDA Approves Camizestrant for ESR1-Mutated HR+/HER2– Advanced Breast Cancer

Novel Agent Earns FDA Breakthrough Therapy Designation for HPV+ Oropharyngeal Cancer

Debating Camizestrant, ctDNA Monitoring, and SERENA-6 in HR+ Breast Cancer

Saturated Fat Intake Linked to Greater Mortality in Nonmetastatic Prostate Cancer

How Do Final CAPItello-291 OS Data Shape Capivasertib Use in Breast Cancer?