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Treatment of HER2-Negative EBC

CE / CME

Expert Review of Treatment for HER2-Negative Early Breast Cancer

Pharmacists: 1.00 contact hour (0.1 CEUs)

Nurses: 1.00 Nursing contact hour

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit™

Released: August 31, 2023

Expiration: August 30, 2024

Kevin Kalinsky
Kevin Kalinsky, MD, MS
CME/CE Information

Activity

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1
Course Completed

Introduction

In this module, Kevin Kalinsky, MD, MS, presents recent clinical data on the treatment of HER2-negative early breast cancer (EBC). He discusses current guideline-recommended biomarker testing, then breaks down the latest strategies for evaluation and treatment of hormone receptor (HR)–positive/HER2-negative EBC, with or without BRCA mutations. Dr. Kalinsky then reviews advances in treatment of early-stage triple-negative breast cancer (TNBC) and mentions ongoing trials evaluating adjuvant and neoadjuvant treatment with immune checkpoint inhibitors (ICIs) and antibody–drug conjugates (ADCs).

Please note that the key points discussed in this module are illustrated with thumbnails from the accompanying downloadable PowerPoint slidesets, which can be found here or downloaded by clicking any of the slide thumbnails in the module alongside the expert commentary.

Clinical Care Options plans to measure the educational impact of this activity. A few questions will be asked twice: once at the beginning of the activity and then again after the discussion that informs the best choice. Your responses will be aggregated for analysis, and your specific responses will not be shared.

Before continuing with this educational activity, please take a moment to answer the following questions.

For those providing patient care, how many patients with breast cancer do you provide care for in a typical month?

Which of the following assays has an available online tool known as RSClin that incorporates clinical and pathologic features to help individualize risk in node-negative HR-positive/HER2-negative EBC?

A 58-year-old woman who is postmenopausal presents with a 6-cm right breast mass with a suspicious node. Initial breast biopsy reveals invasive ductal carcinoma, grade 3, with the following biomarkers: estrogen receptor 100%, progesterone receptor 60%, HER2 negative by immunohistochemistry, Ki-67 10%. Fine-needle aspiration of a palpable right axillary lymph node reveals adenocarcinoma of the breast, testing positive for pathogenic BRCA2 mutation.


The patient receives neoadjuvant doxorubicin/cyclophosphamide followed by paclitaxel and then undergoes bilateral mastectomy. Right mastectomy specimen reveals a 6-cm invasive ductal carcinoma with minimal CT effect and 2 of 15 positive nodes. She returns to the clinic now to discuss adjuvant treatment options.

Assuming all of the following are available, which would you recommend as next step adjuvant therapy?

You are treating a 46-year-old woman diagnosed with left breast T3N3M0 invasive ductal carcinoma, estrogen receptor positive, progesterone receptor positive, and HER2 negative. She has completed neoadjuvant CT, followed by surgery and adjuvant radiation therapy. She is now receiving adjuvant abemaciclib 150 mg orally twice daily with letrozole. She presents to clinic complaining of having 4-6 watery bowel movements daily despite taking loperamide every 8 hours.

What treatment would you recommend?

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