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HER2+ MBC Research UPDATE 2020

Research conferences look a bit different this year. It is all done on virtual platforms due to Covid-19. Sure, I am saving money on flights and hotels but I am totally missing the energy and connection that comes with being in the same room as scientists, researchers, oncologist and patient advocates. However, being able to listen to a conference while getting my life saving infusion is pretty cool.

With that being said. There is good stuff happening in the world of breast cancer research. Just last year in my first Research blog I mentioned that they were no medication for brain mets. Just recently, the FDA approved 2 new meds for HER2+ breast cancer. One is Tucatanib, this is a small molecule drug that can cross the blood brain barrier. 50% of MBC patients that are HER2+ and triple negative will get brain mets.

The other new med is Trastuzumab deruxtecan (ENHERTU) this is an antibody drug conjugate. What that means is they take a HER2 drug, typically Herceptin, and pair it with chemo drug. This conjugate goes in and attaches directly to the HER2+cancer cell. We already had this type of drug with TDM-1 but what makes this drug better is that it has a bystander effect. This means that once the chemo is released inside the HER2+ cancer cell it can then release the chemo outside the cell and kill neighboring cancer cells even ones that are not HER2+. This is important as most breast cancer tumors are heterogenous. This means that there is a mix of HER2+ cancer cells and quite possible other cancer cells that don't respond to HER2+ treatment. So this bystander affect can target those other cancer cells.

Nancy Lin from the Dana Farber Institute discussed the potential for Liquid biopsy to be the future for watching changes with tumor response in metastatic patients. Research is showing that liquid and tumor biopsy are displaying similar gene sequences. Since liquid biopsy are less invasive this will be a great choice for some metastatic patients to learn about their tumor load and what meds might work to slow progression.

Finally, to end the year with this slide: Are some patients with MBC curable? Could we find a cure? Are some of the medications that we are currently using possibly a cure? This seems quite feasible with HER2+ breast cancer with de novo presentation. That is me. That is my wish. With funding stage four MBC research and participation in clinical trials; my hope is that some day we can ALL be cured.

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