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Breast Cancer • Medical Oncology
How do you approach a BRCA-mutated, premenopausal woman with metastatic ER+, Her2+ carcinoma with progression on THP?
The patient initially had a great response to THP for four months, but now with quite a bit of lung, pleural, and nodal involvement.
Answer from: Medical Oncologist at Community Practice
This is probably not a common scenario, but one that theoretically crosses 3 areas of metastatic disease with largely non overlapping clinical trial data. It is somewhat unusual because premenopausal women with ER-positive/HER2 positive breast cancer have disease that is typically sensitive to estro...
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Answer from: Medical Oncologist at Academic Institution
The case describes a fair amount of visceral disease and progression relatilvely early in the course of THP (4months), so I would lean towards either another chemotherapy with trastuzumab or T-DM1. The EMILIA study demonstrated improved outcomes compared to capecitabine and lapatinb and although thi...