Released: July 24, 2025
Ado-trastuzumab emtansine [prescribing information]. South San Francisco, CA: Genentech; 2024.
André F, Hee Park Y, Kim SB, et al. Trastuzumab deruxtecan versus treatment of physician's choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): a randomised, open-label, multicentre, phase 3 trial. Lancet. 2023;401:1773-1785.
Bardia A, Hu X, Dent R, et al. Trastuzumab deruxtecan after endocrine therapy in metastatic breast cancer. N Engl J Med. 2024;391:2110. NCT04494425.
Baselga J, Cortés J, Kim SB, et al. Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. N Engl J Med. 2012;366:109-119.
Cobleigh M, Yardley DA, Brufsky AM, et al. Baseline characteristics, treatment patterns, and outcomes in patients with HER2-positive metastatic breast cancer by hormone receptor status from SystHERs. Clin Cancer Res. 2020;26:1105-1113.
Cortés J, Kim S, Chung W, et al. Trastuzumab deruxtecan (T-DXd) vs trastuzumab emtansine (T-DM1) in patients (Pts) with HER2+ metastatic breast cancer (mBC): results of the randomized phase III DESTINY-Breast03 study. Presented at: 2021 European Society for Medical Oncology Congress; September 16-21, 2021. Abstract LBA1.
Curigliano G, Mueller V, Borges VF, et al. Updated results of tucatinib versus placebo added to trastuzumab and capecitabine for patients with pretreated HER2+ metastatic breast cancer with and without brain metastases (HER2CLIMB). Presented at: 2021 American Society of Clinical Oncology Annual Meeting; June 4-8, 2021. Abstract 1043.
Dent SF, Morse A, Burnette S, et al. Cardiovascular toxicity of novel HER2-targeted therapies in the treatment of breast cancer. Curr Oncol Rep. 2021;23:128.
Fam-trastuzumab deruxtecan-nxki [prescribing information]. Basking Ridge, NJ: Daiichi Sankyo; 2025.
Giordano SH, Franzoi, MAB, Temin S, et al. Systemic therapy for advanced human epidermal growth factor receptor 2-positive breast cancer: ASCO guideline update. J Clin Oncol. 2022;40:2612-2635.
Harbeck N, Ciruelos E, Jerusalem G, et al. Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases: a phase 3b/4 trial. Nat Med. 2024;30:3717-3727.
Hesketh PJ, Kris MG, Basch E, et al. Antiemetics: ASCO guideline update. J Clin Oncol. 2020;38:2782-2797.
Hurvitz A, Modi S, Li W, et al. A pooled analysis of trastuzumab deruxtecan (T-DXd) in patients (pts) with HER2-positive (HER2+) metastatic breast cancer (mBC) with brain metastases (BMs) from DESTINY-Breast (DB) -01, -02, and -03a. Presented at: 2023 European Society for Medical Oncology; October 20-24, 2023. Abstract 3770.
Hurvitz S, O’Shaughnessy J, Mason G, et al. Central nervous system metastasis in patients with HER2-positive metastatic breast cancer: patient characteristics, treatment, and survival from SystHERs. Clin Cancer Res. 2019;25:2433-2441.
Hurvitz SA, Hegg R, Chung WP, et al. Trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer: updated results from DESTINY-Breast03, a randomised, open-label, phase 3 trial. Lancet. 2023b;401:105-117.
Jhaveri KL, Eli LD, Hurvitz SA, et al. Neratinib + fulvestrant + trastuzumab for HR-positive, HER2-negative, HER2-mutant metastatic breast cancer: outcomes and biomarker analysis from the SUMMIT trial. Ann Oncol. 2023;34:885-898.
Lin NU, Murthy RK, Abramson V, et al. Updated results of tucatinib vs placebo added to trastuzumab and capecitabine for patients with previously treated HER2-positive metastatic breast cancer with brain metastases (HER2CLIMB). Presented at: San Antonio Breast Cancer Symposium; December 7-10, 2021. Poster PD4-04.
Lin UL, Borges V, Anders C, et al. Intracranial efficacy and survival with tucatinib plus trastuzumab and capecitabine for previously treated HER2-positive breast cancer with brain metastases in the HER2CLIMB trial. J Clin Oncol. 2020;38:2610-2619.
Marchiò C, Annaratone L, Marques A, et al. Evolving concepts in HER2 evaluation in breast cancer: heterogeneity, HER2-low carcinomas and beyond. Semin Cancer Biol. 2021:72:123
Margetuximab [prescribing information]. Deerfield, IL: TerSera Therapeutics; 2024.
Metzger O, Mandrekar S, DeMichele A, et al. AFT-38 PATINA: a randomized, open label, phase III trial to evaluate the efficacy and safety of palbociclib + anti-HER2 therapy + endocrine therapy vs. anti-HER2 therapy + endocrine therapy after induction treatment for hormone receptor-positive (HR+)/HER2-positive metastatic breast cancer. Presented at: 2024 San Antonio Breast Cancer Symposium; December 10-13, 2024. Abstract GS2-12.
Modi S, Jacot W, Yamashita T, et al. Trastuzumab deruxtecan in previously treated HER2-low advanced breast cancer. N Engl J Med. 2022;387:9-20.
National Comprehensive Cancer Network. Clinical practice guidelines in oncology: breast cancer. v.4.2025. nccn.org. Accessed July 1, 2025.
Neratinib [prescribing information]. Los Angeles, CA: Puma Biotechnology; 2022.
Pertuzumab [prescribing information]. South San Francisco, CA: Genentech; 2025.
Ramakrishna N, Anders CK, Lin NU, et al. Management of advanced human epidermal growth factor receptor 2–positive breast cancer and brain metastases: ASCO guideline update. J Clin Oncol. 2022;40:2636-2655.
Ran R, Huang W, Li Y, et al. Prognostic value of plasma HER2 gene copy number in HER2-positive metastatic breast cancer treated with first-line trastuzumab. Onco Targets Ther. 2020;13:4385-4395.
Rimawi M, Ferrero J-M, de la Haba-Rodriguez J, et al. First-line trastuzumab plus an aromatase inhibitor, with or without pertuzumab, in human epidermal growth factor receptor 2-positive and hormone receptor-positive metastatic or locally advanced breast cancer (PERTAIN): a randomized, open-label phase II trial. J Clin Oncol. 2018;36:2826-2835.
Tarantino P, Hamilton E, Tolaney SM, et al. HER2-low breast cancer: pathological and clinical landscape. J Clin Oncol. 2020;38:1951-1962.
Tarantino P, Modi S, Tolaney SM, et al. Interstitial lung disease induced by anti-ERBB2 antibody-drug conjugates: a review. JAMA Oncol. 2021;7:1873-1881.
Timmins HC, Li T, Trinh T, et al. Weekly paclitaxel-induced neurotoxicity in breast cancer: outcomes and dose response. Oncologist. 2021;26:366-374.
Tolaney S, Jian Z, Zhang Q, et al. Trastuzumab deruxtecan (T-DXd) + pertuzumab (P) vs taxane + trastuzumab + pertuzumab (THP) for first-line (1L) treatment of patients (pts) with human epidermal growth factor receptor 2-positive (HER2+) advanced/metastatic breast cancer (a/mBC): interim results from DESTINY-Breast09. Presented at: 2025 American Society of Clinical Oncology Annual Meeting; May 31-June 2, 2025. Abstract LBA1008.
Tolaney SM, Wardley AM, Zambelli S, et al. Abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus standard-of-care chemotherapy in women with hormone receptor-positive, HER2-positive advanced breast cancer (monarHER): a randomised, open-label, phase II trial. Lancet Oncol. 2020;21:763-775.
Trastuzumab [prescribing information]. South San Francisco, CA: Genentech; 2024.
Tripathy D, Brufsky A, Cobleigh M, et al. De novo versus recurrent HER2-positive metastatic breast cancer: patient characteristics, treatment, and survival from the SystHERs registry. Oncologist. 2020;25:e214-e222.
Tucatinib [prescribing information]. Bothell, WA: Seattle Genetics; 2023.
Velasco R, Bruna J. Taxane-induced peripheral neurotoxicity. Toxics. 2015;3:152-169.
Viale G, Basik M, Niikura N, et al. Retrospective study to estimate the prevalence and describe the clinicopathological characteristics, treatments received, and outcomes of HER2-low breast cancer. ESMO Open. 2023;8:101615.
Wolff AC, Hale Hammond ME, Allison KH, et al. Human epidermal growth factor receptor testing in breast cancer: American Society of Clinical Oncology/College of American Pathologist Clinical Practice Guideline Focused Update. J Clin Oncol. 2018;36:2105-2122.
Wolff AC, Somerfield MR, Dowsett M, et al. Human epidermal growth factor receptor 2 testing in breast cancer. Arch Pathol Lab Med. 2023;147:993-1000.
Yang J, Ju Jie, Guo L, et al. Prediction of HER2-positive breast cancer recurrence and metastasis risk from histopathological images and clinical information via multimodal deep learning. Comput Struct Biotechnol. 2021;20:333-342.
Zhang H and Peng Y. Current biological, pathological and clinical landscape of HER2-low breast cancer. Cancers (Basel). 2022;15:126.
Access to and use of this Interactive Decision Support Tool titled, “Interactive Decision Support Tool: Expert Treatment Guidance for HER2-Positive Metastatic Breast Cancer” is provided subject to the following terms and conditions. PLEASE READ THESE TERMS CAREFULLY.
This Interactive Decision Support Tool is designed to educate healthcare professionals on making optimal systemic treatment selection for patients with HER2-positive metastatic breast cancer. The information provided in the tool is based on the latest guideline recommendations and expert guidance of Shipra Gandhi, MD, MS; Reshma Mahtani, DO; Laura Spring, MD; Erica L. Mayer, MD, MPH, FASCO; and Heather McArthur, MD, MPH, FASCO.
The material published by Clinical Care Options (CCO) reflects the views of the reviewers or authors of the CCO material, not those of Clinical Care Options, LLC, the accredited provider, or the companies providing educational grants. The materials may discuss uses and dosages for therapeutic products that have not been approved by the FDA. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or using any therapies described in these materials.
Although the information contained in the “Interactive Decision Support Tool: Expert Treatment Guidance for HER2-Positive Metastatic Breast Cancer” has been produced and processed from sources believed to be reliable, no warranty, expressed or implied, is made regarding the accuracy, adequacy, completeness, legality, reliability, or usefulness of any information. This disclaimer applies to both the isolated and aggregate uses of the information. CCO provides this information on an as-is basis. This disclaimer applies to all material published by CCO including but not limited to medical information or opinions. All warranties of any kind, expressed or implied, including but not limited to the implied warranties of merchantability, fitness for a particular purpose, freedom from contamination by computer viruses, and noninfringement of proprietary rights are disclaimed.
Any trademarks are the property of respective companies.
© 2025 Clinical Care Options, LLC. All rights reserved.