Advancing HER2-low breast cancer management: enhancing diagnosis and treatment strategies

Area of Science:

• Oncology
• Pathology
• Pharmacology

Background:

• Novel anti-HER2 antibody-drug conjugates are redefining HER2-negative breast cancer (BC) treatment paradigms.
• A new 'HER2-low' category has emerged, impacting previous classifications of HER2-negative tumors.
• Current recommendations necessitate changes in pathology and medical oncology practices, but geographical access to new therapies may be limited.

Purpose of the Study:

• To summarize the current landscape of HER2-low metastatic breast cancer (mBC) in Central and Eastern Europe (CEE).
• To identify local challenges impacting patient access to testing and treatment for HER2-low mBC.
• To propose action plans to mitigate delays in diagnosis and therapy for HER2-low mBC patients in the CEE region.

Main Methods:

• An expert meeting convened ten regional pathology and oncology opinion leaders from four CEE countries (Bulgaria, Croatia, Serbia, Slovenia).
• The meeting focused on the current situation, local challenges, and potential solutions for HER2-low mBC management.
• Expert opinions were gathered to inform the summary and action plans.

Main Results:

• Significant variability and gaps were identified across the four CEE countries regarding HER2-low epidemiology data.
• Challenges include inconsistent pathology laboratory certification, quality control issues, and varied reimbursement conditions for HER2-low testing and treatments.
• While clinical decisions align with international guidelines, access to innovative treatments is restricted by reimbursement delays or limitations.

Conclusions:

• Timely access to diagnosis and novel treatments for HER2-low mBC patients is critical for improving outcomes.
• Multidisciplinary collaboration and proactive dialogue between clinicians and decision-makers are essential.
• Addressing local challenges in CEE countries is necessary to enhance the care of HER2-low mBC patients.