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For a patient with well differentiated de novo triple positive metastatic breast cancer who did not respond to THP, do you sequence all available HER2 targeted options before endocrine therapy?
Answer from: Medical Oncologist at Community Practice
Endocrine combinations for triple positive breast cancer are honestly a bit understudied. We are starting to get more data in this space, SUMMIT, for example, neratinib + fulvestrant + trastuzumab. I think endocrine based combinations are very interesting and there are likely some tumors that are mo...
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Answer from: Medical Oncologist at Community Practice
Triple-positive breast carcinoma (TPBC) is a subset of HR+/HER2+ tumors expressing both ER and PR. To date, only a few published reports have specifically studied TPBC and have focused on clinical outcomes in the adjuvant setting. (Vici et al., PMID 26910921) (You et al., PMID 30607163). In the...
Answer from: Medical Oncologist at Community Practice
Whenever I hear well differentiated and HER2-positive in the same sentence, I must question whether this is a true HER2-positive disease.About 10% of all breast cancers are ER+/HER2+ and half of those are also PR+, so triple-positive tumors account for only 5% of breast cancer.The vast majority of t...
Answer from: Medical Oncologist at Academic Institution
I agree with both Dr. @Hamilton and Dr. @Massarweh. However, this particular triple positive intrinsic subtype has presented itself as not HER2 responsive. Hence making me suspect a more endocrine-dominant biology. NGS and ESR evaluation with Mamaprint/blueprint subtyping albeit data is still immatu...