HER2-positive breast cancer is diagnosed in up to 20% of all breast cancer cases. HER2-positive breast cancer tends to be more aggressive. So it might have a worse prognosis historically. What are the nuances of HER2-positive breast cancer therapy that we can observe today? What are some advanced treatments on the horizon in the near future?

I believe there are two most promising medications for HER2-positive breast cancer. One is already in current use. It is Tucatinib, a small-molecule tyrosine kinase inhibitor. It demonstrated in the third-line setting an overall survival and progression-free survival benefit. Also, in patients with metastatic brain lesions from breast cancer, that is an unmet medical need. And the other drug is for sure trastuzumab deruxtecan. This is an antibody-drug conjugate with very high potency for HER2-positive disease. In my opinion, trastuzumab deruxtecan can potentially be a new standard of care in the first-line setting of HER2-positive breast cancer. Let me also tell you this. I am quite sure that if we treat all oligometastatic breast cancer diseases, some of these patients can be potentially cured with this new type of approach. In my opinion, antibody-drug conjugates will be new smart chemotherapies that will substitute completely standard chemotherapy in the future.

So this mostly applies to metastatic advanced HER2-positive breast cancer. Is there anything on the horizon for the early primary diagnosis the HER2-positive breast cancer?

Yes, we will start with a new clinical trial using antibody drug-conjugate in the neoadjuvant setting for HER2-positive breast cancer. So the idea is to compare trastuzumab deruxtecan to standard chemotherapy, which is Trastuzumab and Pertuzumab in early HER2-positive breast cancer patients.