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Proposed treatment algorithm for patients with metastatic HER2-positive breast cancer.
Notes: *Preferred. Patients with CNS involvement must be evaluated for local therapy. TDxd and tucatinib+trastuzumab+capecitabine are preferred agents when CNS penetration of a systemic drug is desirable.
Abbreviations: THP, taxane, trastuzumab and pertuzumab; TDM1, ado-trastuzumab emtansine; TDxd, fam-trastuzumab deruxtecan.
