Recommendation 3.1.9
➤ If a patient has not received pertuzumab, clinicians may offer
pertuzumab. (Weak recommendation; IC-B-Ins)
Recommendation 3.2.0
➤ May offer hormonal therapy (in patients with ER+ and/or PgR+ disease).
(Weak recommendation; EB-B-M)
Recommendation 3.2.1 (updated)
➤ May offer abemaciclib combined with trastuzumab and fulvestrant.
(Weak recommendation; EB-B-M)
Timing, Dose, Schedule, and Duration
Recommendation 4.0
➤ If a patient is receiving HER2-targeted therapy and chemotherapy
combinations, the chemotherapy should continue for approximately 4–6
months (or longer) and/or to the time of maximal response, depending
on toxicity and in the absence of progression. When chemotherapy is
stopped, clinicians should continue the HER2-targeted therapy; no
further change in the regimen is needed until the time of progression or
unacceptable toxicities. (Moderate recommendation; EB-I)
Recurrence
Recommendation 5.0
➤ If a patient finished trastuzumab-based adjuvant treatment ≤12
months before recurrence, clinicians should follow the second-line
HER2-targeted therapy-based treatment recommendations. (Moderate
recommendation; EB-I)
Recommendation 5.1
➤ If a patient finished trastuzumab-based adjuvant treatment >12 months
before recurrence, clinicians should follow the first-line HER2-targeted
therapy-based treatment recommendations. (Strong recommendation;
EB-H)
