A UK-based Consultant Medical Oncologist and breast cancer specialist with 20 years of research leadership shares perspectives on the HER2-positive breast cancer treatment landscape in the NHS and UK private sector. Topics covered include the impact of NICE/NHS England commissioning constraints on treatment access, neoadjuvant and adjuvant management including anthracycline-free and response-directed approaches, the role of T-DXd (Enhertu) in residual disease and early-line settings, the 11% ILD risk limiting first-line T-DXd adoption, second- and third-line sequencing of T-DM1, T-DXd, and tucatinib, the case for earlier tucatinib access in brain metastasis patients, biosimilar trastuzumab dynamics in the NHS, reimbursement and Cancer Drugs Fund pathways, and key areas of unmet need including HER2-positive brain metastases and treatment withdrawal in long-term responders. Pipeline interest focuses on a CD47 inhibitor and novel PI3K inhibitors.

This interview was conducted on April 24, 2026.

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