Chemotherapy and HER2-Directed Therapy for Metastatic Breast Cancer

Chemotherapy and HER2-directed therapy for metastatic breast cancer (MBC) continue to play an important role in adding to the overall survival of patients with metastatic disease and the palliation of symptoms. HER2-directed therapy continues to be a space of new drug development with the expansion of antibody-drug conjugates (ADCs) including the recent approval of the agents trastuzumab deruxtecan (TDxD) and trastuzumab-emtansine (T-DM1), which has led to large improvements in overall survival for patients with HER2-positive MBC. Another important advance has been greater understanding of triple-negative breast cancer (TNBC) as a heterogeneous and distinct disease subtype and the demonstration of clinical efficacy for platinum-type agents (cisplatin and carboplatin) in TNBC specifically. Progress in systemic therapy for brain metastases, an evolving understanding of treatments specific to BRCA-deficient breast cancer, and the ongoing introduction of many novel therapies including immunotherapy are all exciting recent developments in this field..