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