Cases from the Community: Investigators Provide Their Perspectives on the Practice Implications of Emerging Clinical Research — A Special Video SupplementCase discussion: A 35-year old woman with ER/PR-negative, HER2-positive BC treated 2 years ago with adjuvant chemotherapy/trastuzumab presents with an isolated breast recurrence
1:47 minutes.
TRANSCRIPTION:
DR LOVE: So 35-year-old woman, Stage II breast cancer that was ER/PR-negative, HER2-positive. She gets chemo/adjuvant trastuzumab and then 2 years later has an isolated breast recurrence, 1.5 cm. Now it’s still ER/PR-negative, HER2-positive, and obviously it’s taken out. But the question that this person had is, would you use trastuzumab and pertuzumab with chemo at this point, readjuvant therapy or Stage IV NED therapy? DR SMITH: Yes. I think I would. This is a 35-year-old woman. She’s got her whole life ahead of her. It’s clearly not good that this has relapsed in the short term. And I would have thought her risk of further recurrence, the risk of her having micrometastatic disease that was going to come back, would be high. So I would certainly treat her with rechallenge trastuzumab and pertuzumab. And the issue would be what chemotherapy we would use. And I seem to remember, I think it was Sandy Swain, but someone made the point that maybe this would be a good example of using vinorelbine instead of rechallenge taxane. And I would think that’s a good idea. It’s empirical, but it makes sense. DR LOVE: Yes. This patient actually had — I should have mentioned, had ACTH adjuvant therapy. DR SMITH: Yes. I’m assuming that she’d had a taxane. And obviously if she hadn’t initially had a taxane, that’s what I would use. But she would have. You could, of course, use it again, but two years later, it’s quite a short tumor-free interval. To me, it’s saying maybe there are some cells there that were taxane-resistant. |