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Some of the drugs that you may hear after progression on a first-line therapy with trastuzumab or pertuzumab plus or minus chemotherapy will be ado-trastuzumab, otherwise known as T-DM1. This is a single agent medication or treatment we give, usually in the second line setting. It’s well tolerated and has been shown to be very efficacious. There’s also fam-trastuzumab, which is basically like that first-line trastuzumab therapy we talked about, but in a different manner. So that failure on trastuzumab does not mean that fam-trastuzumab would not work. This is otherwise known as an HER2. In addition to the HER2 receptor therapy that you’re directing for tumor control, you can also use what are called TKIs or tyrosene kinase inhibitors.
Lapatanib, neratinib and tucatinib. And they’re used in conjunction either with chemotherapy or with HER2 targeted therapy. All that to say, this is why it’s important to talk with your doctor about what are the side effect profiles of each option, and what are your future plans? As you’re staying on top of your cancer, say, you want to travel, you may want to elect for an oral therapy or something that has a longer need, three weeks of light therapy rather than needing something every week. These goals help you kind of determine which is the best tool for you to use. Because the whole point is so that you live a productive, good quality of life while controlling your disease.
