Breast cancer
Management of HER2+ MBC

Erika (47 years old)

Erika is a 47-year-old waitress and was diagnosed with HR+ HER2+ MBC 30 months ago. She has a follow-up visit today.

Assessment summary

  • Premenopausal
  • No relevant comorbidities
  • ECOG PS: 1
  • Medical history:
    • 30 months ago: diagnosis de novo HR+ HER2+ MBC
    • Tumour biology (breast lesion): invasive ductal carcinoma, ER 100%, PgR 100%, HER2 IHC 2+ with amplification (ISH+)
    • First-line treatment for bone and lung metastases:
      • Paclitaxel + trastuzumab-pertuzumab for 22 months (paclitaxel stopped due to neuropathy after 18 infusions)
      • Maintenance dual blockade (trastuzumab-pertuzumab) and endocrine therapy (AI + LHRH analogue)
  • Systematic PET-CT during follow-up: multiple bone progression

Which of the following treatment options would you choose for this patient?