MBC101: The HER2-Low Show
The biggest news out of the June meeting of the American Society of Clinical Oncology (ASCO) was the success of a relatively new drug called Enhertu (trastuzumab deruxtecan) in treating estrogen positive (ER+) and triple negative (TNBC) breast cancers that were also HER2 low. Results of the clinical trial presented at the meeting were so positive that in August the FDA approved the drug for patients with metastatic HER2 low breast cancer that has progressed on other treatments.
Most of us likely learned our cancer’s positive or negative HER2 status when we were diagnosed. But how can you find out if you’re HER2 low? And what does this mean for treatment?
In this episode, pathologist David G. Hicks MD, Professor and Director of IHC-ISH Laboratory Breast Subspecialty Service at the University of Rochester, and Maryam Lustberg MD, MPH, Director of the Center for Breast Cancer at Smilow Cancer Hospital and Chief of Breast Medical Oncology at Yale Cancer Center, help the Our MBC Life team understand HER2 low and what it means for treatment.
Spoiler alert: In its Phase III clinical trial, Enhertu significantly extended both progression-free survival and overall survival versus standard of care chemotherapy—an outcome that earned its research team a standing ovation at ASMO. However, the drug has significant side effects, and Our MBC Life’s Natalia Green shares her experience with her own treatment.
Resources
https://www.esmoopen.com/article/S2059-7029(22)00181-8/fulltext
https://www.sciencedirect.com/science/article/abs/pii/S0740257022000570
Meet the Guests of this Episode
David G. Hicks, MD, is currently the director of the IHC/ISH Laboratory and Chief of the Breast Subspecialty Service at the University of Rochester Medical Center. Dr. Hicks is a western New York native and earned his medical degree from the University of Rochester School of Medicine and Dentistry. His postgraduate training includes an internship in internal medicine and a residency in anatomic pathology at the Hospital of the University of Pennsylvania in Philadelphia.
Dr. Hicks' innovative approaches to improving efficiency and quality in surgical pathology have been highlighted in publications and invited lectures sponsored by national pathology organizations. His organizational interests are in the development of a subspecialty-based surgical pathology system, combining disease-specific diagnostic and prognostic expertise with translational research based on organ systems and disease categories.
Dr. Hick’s current research interests focuses on the molecular genetic profiling of clinical samples from patients with cancer. Much of his recent work has involved a search for new molecular genetic markers to help better understand the prognosis and guide therapeutic management of breast cancer. Dr. Hicks has co-authored over 180 peer reviewed articles that have appeared in a variety of Journals and is also the author of a popular Breast Pathology textbook published by Elsevier. He also served as a member of the ASCO/CAP consensus panel for both the ER/PR and HER2 testing guidelines. Dr. Hicks has presented numerous workshops and platform presentations for at the ASCP, USCAP and the CAP annual meetings over the years. Dr. Hicks is an avid golfer and is most proud of his role as “Grandpa” for 8 beautiful grandchildren as well as his role as a mentor and advisor for junior faculty helping them to build their academic careers.
Maryam Lustberg MD MPH is a breast medical oncologist. She currently serves as Chief of Breast Oncology and Director of the Breast Center at Yale Cancer Center in New Haven Connecticut. She is the co-chair of Symptom Intervention for Alliance Clinical Trials and is the President of MASCC, an international organization devoted to improving cancer supportive care throughout the globe. Clinically she treats men and women with all stages of breast cancer with a focus on personalizing all aspects of cancer care.
You can find her on twitter at @maryam_lustberg
Natalia is a 37 years old with metastatic breast cancer, currently living in a suburb outside of Salt Lake City, UT. She is a mother of a 4 and 6 year old. She was diagnosed with early stage breast cancer in 2017 and metastatic breast cancer in 2019.
Before breast cancer, Natalia graduated with a Master of Public Administration from ASU and has a passion for public service and activism. Currently Natalia is a host and senior producer for Our MBC Life podcast. Natalia advocates for breast cancer awareness and education, primarily in the latinx community and for people of color.
Outside of her activism, Natalia enjoys the outdoors, traveling (when possible), cooking, and spending time with her family. “
