Valentina Guarneri, MD

Invited discussant of the HER2CLIMB-02 trial, Valentina Guarneri, MD, of Padeva Istituto Oncologica Veneto, Italy, hailed these results as important, especially for patients with HER2-positive breast cancer and brain metastases. However, she noted, “HER2CLIMB-02 is not likely to challenge the current treatment algorithm for second-line treatment. Second-line treatment is currently fam-trastuzumab deruxtecan-nxki [T-DXd], which achieved a median progression-free survival of 28.8 months vs 6.8 months with T-DM1 [ado-trastuzumab emtansine] in the DB03 trial. However, patients with brain metastases were not included in the DB03 trial.”

“In my view, tucatinib plus capecitabine and T-DM1 can challenge the combination of tucatinib, capecitabine, and pertuzumab, the current standard of care. However, we still need central nervous system progression-free survival data from HER2CLIMB-02,” she stated. 

DISCLOSURE: Dr. Guarneri has served on the advisory board to AstraZeneca, Daiichi Sankyo, Eisai, Eli Lilly, Exact Sciences, Gilead Sciences, Merck Serono, MSD, Novartis, Pfizer, Olema Oncology, Pierre Fabre; has been an invited speaker for AstraZeneca, Daiichi Sankyo, Eli Lilly, Exact Sciences, Gilead Sciences, GSK, Novartis, and Zentiva; and has given expert testimony for Eli Lilly.