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Changing the Paradigm in HER2-Positive Early Breast Cancer

Podcast

The DESTINY-Breast11 and DESTINY-Breast05 trials of trastuzumab deruxtecan are changing the paradigm for HER2-positive early breast cancer, but the broad new indications leave questions about sequencing and patient choice. Listen to Shanu Modi, MD, and Sara A. Hurvitz, MD, FACP, discuss how they are incorporating these changes into clinical practice in the neoadjuvant, adjuvant, and possibly metastatic settings.

Released: August 10, 2026

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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:

  • Select appropriate neoadjuvant HER2-targeted regimens for patients with HER2-positive early breast cancer using clinical factors such as tumor size, nodal status, and hormone receptor expression

  • 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

  • Choose evidence-based first- and later-line HER2-targeted regimens in metastatic settings based on prior treatments, CNS involvement, comorbidities, and toxicity risk profiles

Financial Disclosures

Primary Author
Sara A. Hurvitz, MD, FACP: consultant/advisor: Akari, ALX Oncology, Bayer, BeiGene, BeOne, Blueprint, Boundless Bio, BriaCell, BridgeBio, Bristol Myers Squibb, Daiichi Sankyo, Ellipses, EMBioSys, Gilead, Jazz, Lilly Oncology, Luminate, Mersana, Myricx, Prelude Therapeutics, Roche; researcher: AstraZeneca/Daiichi Sankyo, Novartis, Stemline/Menarini; data and safety monitoring board: Alliance Foundation, InClin/Atossa, Quantum Leap, Roche; stocks: ROMTech; other financial or material support: AstraZeneca, Gilead.

Shanu Modi, MD: researcher (paid to institution): ALX Oncology, AstraZeneca, BioNTech, BriaCell, D3 Bio, Daiichi Sankyo, Duality Bio, Genentech, Nuvation, Pfizer, Seattle Genetics; consultant/advisor/speaker: AstraZeneca, Ataraxis, Bayer, BioNTech, Boehringer Ingelheim, Bristol Myers Squibb, D3 Bio, Daiichi Sankyo, Genentech, Gilead, GSK, Lilly, MacroGenics, Nuvation Bio, Pfizer, Seattle Genetics.