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Striving to Step Up Her Future 1L Treatment Options for HR +/HER2 + mBC

Up your understanding of HR+/HER2+ mBC

1L=first-line; HR+=hormone receptor-positive; HER2+=human epidermal growth factor receptor 2-positive; mBC=metastatic breast cancer.

HR+/HER2+ subtype accounts for approximately
10% of all breast cancers.
This subtype is associated with poorer prognoses than some other tumor types.1

Key Facts About HR+/HER2+ mBC

Additional terminology

HR+/HER2+ is sometimes referred to as triple-positive* or double-positive breast cancer.2,3

It’s distinct

HR+/HER2+ breast cancer is a subtype distinguished by the presence of two biomarkers that drive the disease.1

Clinical studies

Historically, there have not been many studies specifically for patients with the HR+/HER2+ subtype, which has limited knowledge for these patients.1

Continued understanding of the triple-positive subtype may lead to different approaches for management strategy and improved patient experience.1

Unique Tumor Biology

HR+/HER2+ mBC is associated with bidirectional crosstalk between the HR and HER2 pathways. This phenomenon, known as “crosstalk,” can lead to single pathway resistance, resulting in disease progression despite initial treatment effect.2

Unmet Need

Patients diagnosed with HR+/HER2+ mBC eventually experience disease progression. Historically, survival rates remain around 46% at 5 years after diagnosis. Additional research is needed in the effort to address limitations of current options for patients with an HR+/HER2+ mBC diagnosis.2,5
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Illustration of HR and HER2 bidirectional crosstalk mechanism of disease in metastatic breast cancer

Let’s Talk About Crosstalk in HR+/HER2+ mBC

HR, particularly ER, and HER2 are the two most common drivers in breast cancer. Bidirectional crosstalk between HR and HER2 pathways can lead to continued tumor proliferation when one pathway is leveraged to compensate for the other. Therefore, crosstalk may result when both receptors are upregulated.1,2,4

While progress has been made in the management of HR+/HER2+ mBC, research is ongoing in the hope of finding different approaches that inhibit both the HR and HER2 signaling pathways. Find out more about the complexities of HR+/HER2+ mBC and crosstalk below.2,3

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Hear the Experts’ Perspectives

Drs. Bachelot, Janni, Saura, and Tripathy discuss crosstalk and disease challenges in HR+/HER2+ mBC. First, they discuss unmet needs for patients with HR+/HER2+ mBC. Then they explore HR+/HER2+ mBC disease mechanisms. Finally, they examine the current and future clinical landscape.

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Video thumbnails for doctors discussing disease challenges

* Hormone receptor status is sometimes subdivided into estrogen receptor status and progesterone receptor status. Thus, ER+/PgR+/HER2+ breast cancer may be referred to as “triple-positive,” and HR+/HER2+ breast cancer may be referred to as “double-positive.”2,3

ER+=estrogen receptor-positive; PgR+=progesterone receptor-positive.

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Kay C, Martinez-Peréz C, Meehan J, et al. Current trends in the treatment of HR+/HER2+ breast cancer. Future Oncol. 2021;17(13):1665-1681.
Thanopoulou E, Khader L, Caira M, et al. Therapeutic strategies for the management of hormone receptor-positive, human epidermal growth factor receptor 2-positive (HR+/HER2+) breast cancer: a review of the current literature. Cancers (Basel). 2020;12(11):3317.
Pegram M, Pietras R, Dang CT, et al. Evolving perspectives on the treatment of HR+/HER2+ metastatic breast cancer. Ther Adv Med Oncol. 2023;15:17588359231187201.
Giuliano M, Trivedi MV, Schiff R. Bidirectional crosstalk between the estrogen receptor and human epidermal growth factor receptor 2 signaling pathways in breast cancer: molecular basis and clinical implications. Breast Care (Basel). 2013;8(4):256-262.
Cancer stat facts: female breast cancer subtypes. SEER. Accessed November 2024. https://seer.cancer.gov/statfacts/html/breast-subtypes.html