The treatment of HER2-positive metastatic breast cancer (mBC) has advanced significantly in recent decades. Trastuzumab, introduced in 1998, improved survival when added to chemotherapy. Since then, other HER2-targeted agents like pertuzumab, T-DM1, and lapatinib have been approved, further extending progression-free and overall survival. These treatments have given most patients 2-4 years of disease control, but resistance still eventually develops. New strategies aim to prevent or overcome resistance by employing antibody-drug conjugates and combinations to hit multiple targets. The goal is to utilize all effective options in a sequential or combinatorial way until loss of benefit, thereby extending survival as long as possible.

HER2-positive breast cancer has a higher risk of recurrence even after standard chemotherapy and trastuzumab treatment. Neoadjuvant therapy prior to surgery provides benefits like potential downstaging and increased operability. Additionally, achieving pathological complete response (pCR) with neoadjuvant treatment correlates with improved survival. Optimal evaluation and selection of appropriate candidates for neoadjuvant therapy is thus critical. This review examines systemic neoadjuvant and adjuvant treatment strategies for HER2+ breast cancer to help guide clinical decision-making surrounding therapy selection. Key factors are assessing nodal involvement and recurrence risk to determine best approach, considering postsurgical outcomes with each strategy, and utilizing adjuvant T-DM1 if pCR is not achieved with neoadjuvant therapy in the case of residual disease.

This presentation is going to talk about the evolution of combination of target therapy and chemotherapy, standard regimens including anthracycline based, anthracycline-free and Taxane. For low risk patients or patients with comorbidities, how to balance between efficacy and side effect profile?

Last but not least, Dr. Tsai will talk about her insights on cancer treatment without chemotherapy. 

As a groundbreaking anti-cancer drug, T-DXd has demonstrated significant efficacy in clinical trials for patients with HER2-low metastatic breast cancer (mBC). This lecture aims to explore the optimal utilization of T-DXd in the treatment of HER2-low mBC and provide precise treatment recommendations based on patient-specific characteristics. 

Due to the high prevalence rate of breast cancer, treatment of breast cancer has been a big topic over decades. The treatment paradigm of breast cancer shifts with time and medicine development, from CMF to Anthracyclines, and Taxane. We foresee more and more different classes of drugs would evolve and help too. 

This presentation will review the current treatment of early breast cancer and share insights on the pros and cons of different regimens based on clinical evidence.

Anthracyclines have been a mainstay of breast cancer therapy for decades, with strong evidence demonstrating their impact on breast cancer survival. Apart from the proven efficacy, associated toxicity has raised concern on the use of anthracyclines and turned the spotlight on anthracycline-free regimens.
This presentation will review the role of anthracyclines in treatment of early breast cancer and share insights on anthracycline-free regimen based on clinical evidence.