Breast cancer (invasive) · Tucatinib + trastuzumab + capecitabine (HER2+ metastatic ≥3L, especially with brain metastases)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.
| Track | standard |
|---|---|
| Linked regimen | REG-TUCATINIB-TRASTUZUMAB-CAPECITABINE-BREAST |
| ID | IND-BREAST-HER2-POS-3L-TUCATINIB |
|---|---|
| Type | Indication |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | DIS-BREAST |
| Sources | SRC-ESMO-BREAST-METASTATIC-2024 SRC-HER2CLIMB-MURTHY-2019 SRC-NCCN-BREAST-2025 |
Notes
ESCAT IA. HER2CLIMB established tucatinib + trastuzumab + capecitabine for HER2+ metastatic ≥3L (post-trastuzumab + post-T-DXd in current era). Major unmet need addressed: active brain metastases — first regimen with prospectively-demonstrated intracranial activity. CNS-PFS doubling justifies preferred positioning when brain mets present (active or treated). MRI brain required pre-treatment to characterize CNS disease. Diarrhea management dominant clinical workflow burden — combined effect of tucatinib + capecitabine. UA access barrier: tucatinib not registered; named-patient import / EAP only. T-DM1 remains an alternative when tucatinib not accessible (KATHERINE / EMILIA data — not modeled in this batch).
Used By
Algorithms
ALGO-BREAST-HER2-POS-2L- ALGO-BREAST-HER2-POS-2L
Handbook Chapters
HB-BREAST-HER2-POS-MET-1L- HER2+ metastatic breast cancer: first-line reasoning