"Key thing here is that it was discovered that when you have gene amplification of HER2 you get a resultant overexpression of that HER protein and that overexpression leads to a driver for certain cancers. So, when you have an overexpression of HER2, it leads to the cancer being more aggressive," ONS member Rowena "Moe" Schwartz, PharmD, BCOP, FHOP, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about HER inhibitors.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: The learner will report an increase in knowledge related to HER inhibitor drugs.

Episode Notes

• The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast™ episodes. Find a full list of opportunities.
• Oncology Nursing Podcast™ Pharmacology 101 series
• ONS Voice articles:
  • Antibody–Drug Conjugates Join the Best of Two Worlds Into One New Treatment
  • HER2 Therapies May Be Effective in a Variety of Solid Tumors
  • Management Strategies for Cutaneous Toxicity From EGFR Inhibitors
  • Manage Common Ocular Toxicities From Tyrosine Kinase Inhibitors
  • Oncology Drug Reference Sheet: Combination Trastuzumab and Hyaluronidase-Oysk
  • Oncology Drug Reference Sheet: Elacestrant
  • Oncology Drug Reference Sheet: Margetuximab-Cmkb
  • Oncology Drug Reference Sheet: Talazoparib
• ONS book: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (Second Edition)
• ONS courses:
  • ONS Cancer Biology™
  • ONS/ONCC Chemotherapy Immunotherapy Certificate™
  • Safe Handling Basics
• ONS Biomarker Database
• ONS Learning Libraries:
  • Genomics and Precision Oncology
  • Oral Anticancer Medication

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

"It was discovered that when you have gene amplification of HER2, you get a resultant overexpression of that HER protein, and that overexpression leads to a driver for certain cancers. So, when you have an overexpression of HER2, it leads to the cancer being more aggressive. In fact, when we first started talking about HER2 positive breast cancer, the key thing is, if we look at just the disease, not disease and treatment, that the patients that have HER2-positive breast cancers, they tended to be more aggressive because you had those drivers." TS 3:30

"Pertuzumab is also a naked antibody, but it binds to a different part of the extracellular domain. It prevents heterodimerization, so where trastuzumab prevents HER2/HER2, this presents HER2 and HER1, HER2 and HER3, HER2 and HER4 dimerization, and then that leads to downstream effects that causes cell arrest and leads to the benefit of inhibition." TS 6:03

"Key thing here is that we've learned, is that sometimes, that drug, when it's released from the antibody, can be released from the cell and can hit cells around the cancer cell that overexpresses HER2. So that's called the innocent bystander effect. So we're learning a lot more about antibody–drug conjugates." TS 7:35

"The tyrosine kinase inhibitors, they're interesting in that there are these small molecules, just like we know about other tyrosine kinase inhibitors that target intracellular catalytic kinase domain of HER2, so the internal part. Key thing is we have a number of different tyrosine kinase inhibitors and they target different parts of that family." TS 7:54

"The infusion-related reactions are really interesting, because one of the things we do with infusion-related reactions is, if we're giving it in an IV formulation, we use those prolonged infusions for the first dose and then go faster with subsequent doses after we see how they tolerate. And then of course there is the development of these onc products that are given sub-Q that have less of the infusion-related reaction." TS 15:49

"One of the things that I see, I hear, is people say about these antibody–drug conjugates, which, you know, we use in all different diseases now. I hear so many people say these are not chemotherapy, and the thing of it is, they're chemotherapy. I think people like to say they're not chemotherapy because it makes people feel better that they're not getting chemotherapy. But the reality of it is, is that they are monoclonal antibodies linked to a chemotherapy. So some of the side effects that you get are related to the chemotherapy. I think people need to realize that. You need to know what you're giving." TS 18:31