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ASCO Offers Guidance on Managing HER2-Positive Breast Cancer — Physician’s First Watch

Medical News |
May 6, 2014

ASCO Offers Guidance on Managing HER2-Positive Breast Cancer

By Kelly Young

The American Society of Clinical Oncology has published new recommendations for treating women with human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer. In addition, the group offers separate guidelines for treating brain metastases, since up to half of patients with HER2-positive metastatic breast cancer experience brain involvement.

Among the many recommendations, published in the Journal of Clinical Oncology:

  • Patients with HER2-positive advanced breast cancer should receive treatment that targets HER2 unless they have clinical congestive heart failure or reduced left ventricular ejection fraction (these latter patients should be evaluated on a case-by-case basis).

  • The recommended first-line treatment is a combination of trastuzumab, pertuzumab, and a taxane. The recommended second-line therapy is trastuzumab emtansine. For third-line treatment, the guideline gives several options.

  • Patients without known histories or symptoms of brain metastases shouldn't undergo routine screening with brain magnetic resonance imaging. However, clinicians should consider MRI for any neurologic symptoms suggesting brain metastases.

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