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Strategies for Adjuvant Treatment in HER2+ Early-Stage Breast Cancer

Slideset

These slides and accompanying video module review evolving evidence and clinical decision-making for adjuvant therapy in patients with HER2-positive early breast cancer (EBC), with a focus on tailoring treatment according to pathologic response, baseline stage, residual disease burden, and recurrence risk. Key data include long-term outcomes from APHINITY and KATHERINE, emerging evidence from DESTINY-Breast05 comparing adjuvant trastuzumab deruxtecan (T-DXd) with trastuzumab emtansine (T-DM1) in patients with high-risk residual disease, and considerations related to CNS recurrence, treatment toxicity, and reassessment of HER2 status after neoadjuvant therapy. The slides also address extended adjuvant neratinib, endocrine therapy selection in HR-positive/HER2-positive disease, and the evolving choice between neoadjuvant and adjuvant T-DXd, highlighting how these data may inform individualized treatment selection and risk-adapted management in clinical practice.

Released: October 13, 2026

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Faculty

Adrienne G. Waks

Adrienne G. Waks, MD

Senior Physician, Medical Oncology
Associate Director of Breast Clinical Research
Dana-Farber Cancer Institute
Assistant Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Provided by

Provided by Clinical Care Options, LLC dba Decera Clinical Education

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Supporters

This activity is supported by educational grants from AstraZeneca and Daiichi Sankyo, Inc.

AstraZeneca

Daiichi Sankyo, Inc.

Target Audience

This activity is intended for oncologists, advanced practice providers, nurse practitioners, clinical nurse specialists, nurses, pharmacists, and other health care professionals who care for patients with HER2-positive breast cancer.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Determine when to escalate, maintain, or de-escalate therapy during the transition from neoadjuvant to adjuvant treatment, including appropriate use of T-DM1 for residual invasive disease and identification of patients who may benefit from trastuzumab-based maintenance

  • Modify sequencing decisions in response to clinical changes, including therapy discontinuation due to toxicity, HER2 loss after neoadjuvant treatment, ILD risk with ADCs, cardiotoxicity, or evolving patient preferences

Additional Disclosures

Generative artificial intelligence (AI) tools were used for data analysis or summarization influencing content. All AI-assisted content underwent human review, editing, and validation by qualified faculty and accredited education staff to ensure scientific accuracy, balance, and compliance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education.