Empowering patients with breast cancer to talk to their oncologist about HER2 status

In the U.S. alone, an estimated 313,510 new cases of breast cancer will be diagnosed in 2024. For people with metastatic breast cancer, timely access to critical information can make all the difference in treatment options and outcomes. 

One piece of critical information for providers and breast cancer patients is the human epidermal growth factor receptor 2 (HER2) status of a patient’s cancer. This status has been traditionally classified as either HER2-negative or HER2-positive, but recent research has allowed for new classifications, including HER2-low, which have opened new treatment options for cancer patients who previously did not qualify. The hormone receptor (HR) positive/HER2-negative subtype of breast cancer is the most common, with an age-adjusted rate of 90 cases per 100,000 women—over seventeen times higher than HR negative/HER2-positive.

Unfortunately, many patients remain unaware of the HER2-low classification and the valuable insights testing can provide for metastatic breast cancer diagnosis and treatment decisions. Recognizing the need to increase awareness around biomarker testing for those with metastatic breast cancer, Labcorp partnered with Outcomes4Me, creator of the Outcomes4Me cancer treatment recommendation mobile app, to help patients better understand their HER2-low status.

What is HER2? What does HER2-low mean for treatment options?

HER2 is a protein that helps cells grow and survive. Sometimes in patients with breast cancer, tumor cells make too many of these receptors, leading to uncontrolled cell growth and aggressive tumor behavior. To measure the amount of this protein present on a cancer cell, special testing called immunohistochemistry (IHC) is performed on a tissue sample from a patient’s tumor. The measurement is given a numeric value of 0, 1, 2 or 3. IHC scores of 3 are considered HER2-postive. Previously, IHC scores of 0 and 1 were considered HER2-negative, and IHC scores of 2 required further testing to determine whether the patient’s cancer was HER2-negative or HER2-positive. 

Before the classification of HER2-low, only HER2-positive patients (accounting for only 1 in 5 breast cancers) were eligible for HER2-directed targeted therapies. This new classification means that newer, more personalized treatments are available to more breast cancer patients.

The breakthrough discovery of HER2-low classification emerged after the results of the DESTINY-BREAST04 trial were presented at the American Society of Clinical Oncology meeting in 2022. The study showed that the now FDA-approved treatment, ENHERTU® (fam-trastuzumab deruxtecan-nxki), led to significant improvements in survival outcomes in patients with HER2-low breast cancers that were previously deemed HER2-negative.

"We now recognize that the HER2 scoring is more nuanced than a simple positive or negative categorization,” said Dr. Rebecca Ann Previs, director of medical affairs at Labcorp Oncology. “A deeper comprehension of subtle variations in HER2 expression has revealed a subset of patients who could potentially benefit from anti-HER2 treatments. It's been a game changer for patients with metastatic breast cancer."

Increasing awareness of HER2 status and improving outcomes for metastatic breast cancer 

Dr. Maya Said, founder and CEO of Outcomes4Me, contacted the Labcorp Oncology team about collaborating to raise awareness about HER2 testing and HER2-low. Dr. Said knew that a partnership between Outcomes4Me and Labcorp could significantly boost awareness of the link between faster HER2 testing and improved outcomes for patients.

“One of the unique ideas that fuels this partnership is the mission to unlock precision oncology at scale, made possible through Labcorp's extensive diagnostic testing capabilities,” explains Dr. Said.

The strategic collaboration began with an online survey to gauge patients' knowledge about HER2 status. The survey revealed that over half of patients had not discussed HER2-low as a diagnostic possibility with their oncologist. An anonymous survey respondent shared that understanding the nuances of their HER2 status made all the difference in treatment: “Initially, I was told I was HER2-negative. Upon consulting another oncologist, I was told I was HER2-low, not negative. This information gave me options I did not have before.”

Following the initial survey, patients were directed to resources in the Outcomes4Me app tailored for metastatic and early breast cancer patients, and Labcorp designed accessible, patient-friendly materials to enhance communication between patients and their healthcare providers. Outcomes4Me also hosted a Facebook Live event on HER2-low status featuring Dr. Previs.

Together, Labcorp and Outcomes4Me reached more than 10,000 people with breast cancer through the educational campaign. A follow-up survey found that 60% of respondents without prior knowledge of their HER2 status felt very likely or somewhat likely to get testing for HER2-low after learning more about it during the campaign.

Despite the awareness generated from the campaign, ongoing education around HER2-low status is vital to improving outcomes.

“Patients want to have honest conversations with their doctors, so the work with Outcomes4Me allowed us to educate patients on how to advocate for themselves and have more informed discussions,” Dr. Previs said. “We are committed to helping patients talk to their doctors to get the right test at the right time for the right therapy.” Learn more about HER2-low status here.