Keypoints:
• The importance of HER2 testing in biliary tract cancers, including intrahepatic and extrahepatic cholangiocarcinomas and gallbladder cancers.
• Who should be tested for HER2 positivity and how to classify HER2-positive disease.
• The role of next-generation sequencing (NGS) and immunohistochemistry (IHC) in determining HER2 status.
• Current treatment options for HER2-positive biliary tract cancer, including the latest clinical trials and approved therapies like trastuzumab deruxtecan and zanidatamab.
• The significance of patient-centered decision-making and managing side effects associated with these treatments.
• Insights into the potential for brain metastases in biliary tract cancer and the importance of ongoing surveillance.
In this episode of the Oncology Brothers podcast, we continue our discussion on HER2-positive biliary tract cancer, featuring Dr. Shubham Pant from MD Anderson. We delved into the evolving landscape of HER2 testing and treatment options for biliary tract cancers, including intrahepatic and extrahepatic cholangiocarcinomas and gallbladder cancers.
Dr. Pant emphasized the importance of testing all patients for HER2 amplification, as the prevalence varies across different types of biliary tract cancers—ranging from 5% in intrahepatic cholangiocarcinoma to up to 30% in gallbladder cancer. He explained the methods for determining HER2 positivity, including next-generation sequencing (NGS) and immunohistochemistry (IHC), and discussed the significance of these tests in guiding treatment decisions.
We explored the current treatment landscape, highlighting the role of chemoimmunotherapy as the first-line option, regardless of HER2 status. However, we also discussed promising second-line therapies, including trastuzumab deruxtecan and zanidatamab, both of which have shown encouraging response rates in clinical trials. Dr. Pant shared insights on the side effect profiles of these agents and the importance of patient-centered decision-making in treatment planning.
As we wrapped up, we touched on the potential for brain metastases in HER2-positive biliary tract cancer and the need for ongoing surveillance as patients live longer with these targeted therapies.
Accreditation/Credit Designation
Physicians’ Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Physicians’ Education Resource®, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Acknowledgment of Commercial Support
This activity is supported by an educational grant from Jazz Pharmaceuticals, Inc.
Link to gain CME credits from this activity:
https://www.gotoper.com/courses/from-bench-to-bedside-paradigm-shifts-in-her2-metastatic-btc-treatment
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