Mr Henry Cain discusses the neoadjuvant treatment of patients with HER2-positive eBC from a surgeon’s perspective
Mr Henry Cain is a Consultant Oncoplastic Breast Surgeon. He maintains numerous research activities along with a commitment in teaching advanced oncoplastic breast surgery, and has been one of the lead surgeons in the introduction of radioactive seed localisation of impalpable breast cancer to the UK.
In your expert opinion, what is the clinical rationale for treating patients neoadjuvantly?
Mr Henry Cain provides an overview of the traditional reasons for using neoadjuvant treatment and how these have expanded over time to include a greater proportion of patients.
Discussion of experience with PERJETA-trastuzumab in the neoadjuvant setting and impact on eBC patients and surgical outcomes
Mr Cain discusses the changes in outcomes seen with PERJETA-trastuzumab over the past five years.
Service implications of neoadjuvant therapy vs. surgery
Mr Henry Cain outlines the greater resource use associated with neoadjuvant therapy vs going straight to surgery.
Dr Marina Parton discusses the adjuvant treatment of patients with HER2-positive eBC from an oncologist’s perspective
Dr Marina Parton is a Medical Oncologist in Breast Cancer at a large cancer centre and district general hospital in London, and has been consulting since 2009. She is the Lead Cancer Clinician in the centre’s satellite chemotherapy unit, as well as leading breast clinics.
Joint decision making at the multidisciplinary team (MDT)
Dr Marina Parton talks about working with the MDT and its role in finding an agreed approach. She discusses her experience when it comes to choosing the most appropriate treatment options for a patient, the role of the surgical team, and the importance of patient preference.
How do you identify patients that can benefit from adjuvant PERJETA-trastuzumab?
Dr Marina Parton discusses key considerations when choosing a treatment approach and the patients that the MDT are most likely to recommend for PERJETA-trastuzumab.
The patient cases that generate the most discussion in an MDT
Dr Marina Parton describes the patient types that require additional discussions during MDT meetings, including patients with smaller breast tumours, low nodal burden, a low risk of recurrence, or those who achieve a pathological complete response.
The initial consultation with the patient: allowing the patient to plan ahead
Dr Marina Parton explains how she discusses the treatment strategy with the patients, her key considerations, and why having these conversations early on can help patients plan and be prepared for a prolonged period of treatment.
Putting the APHINITY clinical study into context of breast cancer treatment evolution
Dr Marina Parton discusses the ground-breaking introduction of trastuzumab and how improvements observed with this treatment are difficult to emulate. She then focuses on PERJETA, its toxicities, and why it’s a treatment she routinely offers to node-positive patients.
Managing adverse events associated with PERJETA
Dr Marina Parton discusses the experiences of patients receiving PERJETA-trastuzumab, including those who are on long-term metastatic treatment. She then focuses on the patients who experience diarrhoea and the steps the team takes to help patients to complete all planned cycles of treatment.
Read about the goals of treatment for patients with mBC, the efficacy and safety data for PERJETA-trastuzumab plus docetaxel from the CLEOPATRA study, and practical guidance on dosing and administration.4
eBC, early breast cancer; mBC, metastatic breast cancer; MDT, multidisciplinary team.
- von Minckwitz G et al. N Engl J Med. 2017;377(2):122–131.
- Gianni L et al. Lancet Oncol. 2012;13(1):25–32.
- Schneeweiss A et al. Ann Oncol. 2013;24(9):2278–2284.
- Baselga J et al. N Engl J Med. 2012;366(2):109–119.
Date of preparation: September 2020.