Q & A With Dr. Sunil Verma: Targeted Treatments for HER2-Positive Breast Cancer

Sunil Verma, MD, MSEd, FRCPC

In the last decade, there have been tremendous improvements in the treatment of HER2-positive breast cancer with new HER2-targeted agents improving survival in both the adjuvant and metastatic settings. At the Miami Breast Cancer Conference, we spoke about this progress and the current focus of research in the HER2-positive breast cancer setting with breast cancer expert, Sunil Verma, MD, MSEd, FRCPC, an associate professor at the University of Toronto and chair of Breast Medical Oncology at the Sunnybrook Odette Cancer Centre in Toronto, Canada.

What is the current state of HER2-targeted therapy in metastatic disease?

Verma:In metastatic disease, over the past decade, we have seen a nearly doubling of the overall survival (OS) for patients with metastatic HER2-positive breast cancer since the pivotal publication of Slamon et al, in 2001, which showed an improvement from a 20-month to 25-month survival with integration of trastuzumab, and now we are seeing an improvement in OS with the addition of pertuzumab with docetaxel in the CLEOPATRA study, which is beyond 45 months. This survival improvement has been fueled through integration of new agents, such as pertuzumab, and also through the continuation of HER2-positive therapy with trastuzumab and lapatinib. The other key achievement is the development of T-DM1. This is the first time in solid tumors that an antibody-drug conjugate has been shown to be associated with an improvement in OS with superior toxicity profile. And so having both an improved OS with less toxicity is a remarkable achievement for our patients with HER2-positive disease.

What about for HER2-positive therapies in the adjuvant setting?

Verma: