KOL Highlights Include:

• Physicians are starting to use Perjeta (Roche) as an add-on to Herceptin in the adjuvant setting due to a recent change in NCCN (National Comprehensive Cancer Network, an alliance of major cancer centers) guidelines.
• Tykerb (lapatinib, NVS) has poor efficacy relative to Kadcyla (Roche) in HER2-positive patients, and results from studies attempting to expand Tykerb usage to different or earlier lines of therapy have not been impressive.
• Neratinib (PBYI) would need to be better than Kadcyla to garner significant usage in the metastatic setting.
• Kadcyla tolerability is probably better than Herceptin + chemotherapy, so favorable results in studies of Kadcyla in early breast cancer could increase Kadcyla usage.
• This oncologist’s practice does not use Avastin (Roche) despite its presence in the NCCN guidelines, partly due to the lack of OS benefit.
• MammaPrint (Agendia) sometimes gives results that are difficult to interpret and discordant with information generated by Oncotype (Genomic Health, Inc.) and information from this oncologist’s expertise.
• Public awareness has led to an increase in BRCA screening, and BRCA screening would increase further if a PARP inhibitor with a BRCA-mutation population in its label were approved.
• Preliminary results from palbociclib (PFE) are favorable and exciting, and this physician would give letrozole+palbociclib to most eligible patients.
• Past results for therapeutic vaccines for breast cancer do not give this oncologist optimism for the field.
• Halaven (ESALY) has good efficacy as a single-agent cytotoxic in advanced breast cancer.