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                              <font size="4"><b>Complete the survey for $25 USD</b></font>
                              <p>
                                <b>Knowledge/Competence Assessment and Educational Needs Survey</b>
                                <br> You have been selected to participate in a brief survey designed to assess the current knowledge, competence, and educational needs of medical professionals who are actively involved in the diagnosis and
                                management of breast cancer.
                              </p>
                              <p> In appreciation for completing this survey, you will receive a <b>$25 USD honorarium</b>. </p>
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                                <u>Questionnaire Length</u>: 7 questions (approx. 10 minutes).
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                                    <td width="15" valign="top">1. </td>
                                    <td> Based on the current FDA approval, the novel HER2-targeted therapy tucatinib is indicated for: </td>
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                                      <td><input type="radio" name="q1" id="q1_1" value="1"></td>
                                      <td><label for="q1_1" id="q1_1_label">Patients with advanced unresectable or metastatic HER2-positive breast cancer who have received no prior anti-HER2–based regimens in the metastatic setting</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q1" id="q1_2" value="2"></td>
                                      <td><label for="q1_2" id="q1_2_label">Patients with advanced unresectable or metastatic HER2-positive breast cancer, except those with brain metastases, who have received 1 prior anti-HER2–based regimen in the
                                          metastatic setting</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q1" id="q1_3" value="3"></td>
                                      <td><label for="q1_3" id="q1_3_label">Patients with advanced unresectable or metastatic HER2-positive breast cancer, including those with brain metastases, who have received ≥1 prior anti-HER2–based regimen in
                                          the metastatic setting</label></td>
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                                      <td><input type="radio" name="q1" id="q1_4" value="4"></td>
                                      <td><label for="q1_4" id="q1_4_label">Patients with advanced unresectable or metastatic HER2-positive breast cancer, including those with brain metastases, who have received ≥2 prior anti-HER2–based regimens in
                                          the metastatic setting</label></td>
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                                      <td><input type="radio" name="q1" id="q1_5" value="5"></td>
                                      <td><label for="q1_5" id="q1_5_label">I am not sure</label></td>
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                                    <td width="15" valign="top">2. </td>
                                    <td> The phase 3 NALA trial, which evaluated the irreversible pan-HER tyrosine kinase inhibitor neratinib plus capecitabine versus the reversible dual tyrosine kinase inhibitor lapatinib plus capecitabine, has
                                      demonstrated significantly prolonged PFS with neratinib plus capecitabine in which of the following patient populations? </td>
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                                      <td><input type="radio" name="q2" id="q2_1" value="1"></td>
                                      <td><label for="q2_1" id="q2_1_label">No benefit was observed in any of the patient populations in which the combination was tested</label></td>
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                                      <td><input type="radio" name="q2" id="q2_2" value="2"></td>
                                      <td><label for="q2_2" id="q2_2_label">Patients with previously untreated metastatic HER2-positive breast cancer</label></td>
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                                      <td><input type="radio" name="q2" id="q2_3" value="3"></td>
                                      <td><label for="q2_3" id="q2_3_label">Patients with metastatic HER2-positive breast cancer that has progressed after 1 line of HER2-directed treatment</label></td>
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                                      <td><input type="radio" name="q2" id="q2_4" value="4"></td>
                                      <td><label for="q2_4" id="q2_4_label">Patients with metastatic HER2-positive breast cancer that has progressed after at least 2 lines of HER2-directed treatment</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q2" id="q2_5" value="5"></td>
                                      <td><label for="q2_5" id="q2_5_label">I’m not sure</label></td>
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                                    <td width="15" valign="top">3. </td>
                                    <td> Your patient is a 55-year-old woman with HER2-postive metastatic breast cancer who was previously treated with the combination of trastuzumab, pertuzumab, and docetaxel in the first-line setting and
                                      trastuzumab emtansine in the second-line setting. Ten months later, she develops a persistent headache, and MRI reveals brain lesions with minimal edema. She is also found to have new liver lesions. Which
                                      HER2-targeted therapy–based regimen would you recommend for this patient? </td>
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                                      <td><input type="radio" name="q3" id="q3_1" value="1"></td>
                                      <td><label for="q3_1" id="q3_1_label">Neratinib plus capecitabine</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q3" id="q3_2" value="2"></td>
                                      <td><label for="q3_2" id="q3_2_label">Tucatinib plus trastuzumab and capecitabine</label></td>
                                    </tr>
                                    <tr>
                                      <td><input type="radio" name="q3" id="q3_3" value="3"></td>
                                      <td><label for="q3_3" id="q3_3_label">Margetuximab plus capecitabine</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q3" id="q3_4" value="4"></td>
                                      <td><label for="q3_4" id="q3_4_label">Trastuzumab deruxtecan</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q3" id="q3_5" value="5"></td>
                                      <td><label for="q3_5" id="q3_5_label">Continue on trastuzumab emtansine</label></td>
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                                      <td><input type="radio" name="q3" id="q3_6" value="6"></td>
                                      <td><label for="q3_6" id="q3_6_label">I’m not sure</label></td>
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                                    <td width="15" valign="top">4. </td>
                                    <td> You are managing a 50-year-old patient with HER2-overexpressed breast cancer for whom you are considering treatment with the combination of neratinib and capecitabine. She expresses concern about the potential
                                      for diarrhea as an adverse effect of the therapy and is asking for guidance on preventive approaches. Which of the following would you recommend as the best option for reducing the potential for development of
                                      diarrhea in your patient? </td>
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                                      <td><input type="radio" name="q4" id="q4_1" value="1"></td>
                                      <td><label for="q4_1" id="q4_1_label">I would give the patient loperamide 4 mg three times a day as prophylaxis for the first two 4-week cycles and loperamide (≤16 mg/day) PRN after completion of loperamide
                                          prophylaxis</label></td>
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                                      <td><input type="radio" name="q4" id="q4_2" value="2"></td>
                                      <td><label for="q4_2" id="q4_2_label">I would give the patient budesonide 9 mg daily in the morning on days 1-28 of cycle 1 plus loperamide prophylaxis the first two 4-week cycles</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q4" id="q4_3" value="3"></td>
                                      <td><label for="q4_3" id="q4_3_label">I would give the patient colestipol 2 g orally twice daily for the first cycle plus loperamide 4 mg three times a day as prophylaxis for the first two 4-week cycles and
                                          loperamide (≤16 mg/day) PRN after completion of loperamide prophylaxis</label></td>
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                                      <td><input type="radio" name="q4" id="q4_4" value="4"></td>
                                      <td><label for="q4_4" id="q4_4_label">I would use the approach of escalating the doses of neratinib weekly (120 mg/day on days 1-7, 160 mg/days on days 8-14, and 240 mg/day thereafter) and give the patient
                                          loperamide (≤16 mg/day) PRN</label></td>
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                                      <td><input type="radio" name="q4" id="q4_5" value="5"></td>
                                      <td><label for="q4_5" id="q4_5_label">I’m not sure</label></td>
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                                    <td width="15" valign="top">5. </td>
                                    <td> Your patient is a 58-year-old woman with HER2-positive metastatic breast cancer who received first-line therapy with docetaxel, trastuzumab, and pertuzumab, but 20 months later, she developed progression in
                                      the liver, with a new 1-cm metastasis, as well as new lung metastases. Which of the following would you recommend for your patient next, taking into account the latest evidence and practice guidelines? </td>
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                                      <td><input type="radio" name="q5" id="q5_1" value="1"></td>
                                      <td><label for="q5_1" id="q5_1_label">Trastuzumab emtansine</label></td>
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                                      <td><input type="radio" name="q5" id="q5_2" value="2"></td>
                                      <td><label for="q5_2" id="q5_2_label">Trastuzumab deruxtecan</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q5" id="q5_3" value="3"></td>
                                      <td><label for="q5_3" id="q5_3_label">Neratinib + capecitabine</label></td>
                                    </tr>
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                                      <td><input type="radio" name="q5" id="q5_4" value="4"></td>
                                      <td><label for="q5_4" id="q5_4_label">Tucatinib plus trastuzumab and capecitabine</label></td>
                                    </tr>
                                    <tr>
                                      <td><input type="radio" name="q5" id="q5_5" value="5"></td>
                                      <td><label for="q5_5" id="q5_5_label">Margetuximab plus capecitabine</label></td>
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                                      <td><input type="radio" name="q5" id="q5_6" value="6"></td>
                                      <td><label for="q5_6" id="q5_6_label">I’m not sure</label></td>
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                                    <td width="15" valign="top">6. </td>
                                    <td> How often do you currently do the following? </td>
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                                      <th id="q6_header1" class="qigscale" style="width:40px">Never<br>1</th>
                                      <th id="q6_header2" class="qigscale" style="width:40px">Infrequently<br>2</th>
                                      <th id="q6_header3" class="qigscale" style="width:40px">Sometimes<br>3</th>
                                      <th id="q6_header4" class="qigscale" style="width:40px">Frequently<br>4</th>
                                      <th id="q6_header5" class="qigscale" style="width:40px">Always<br>5</th>
                                      <th id="q6_header6" class="qigscale" style="width:40px">N/A<br>&nbsp;</th>
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                                      <th class="qiggridlabel">Consider the indications, unique characteristics and efficacy/safety profiles, and evidence-based use of different HER2-targeting agents when making individualized treatment
                                        recommendations for patients with HER2-positive breast cancer</th>
                                      <td headers="q6_header1" class="qiginput" id="yui_3_14_1_8_1640732973362_109"><input type="radio" name="q6_1" id="q6_1_1" value="1">
                                        <div class="confirmit-hidden"><span>Consider the indications, unique characteristics and efficacy/safety profiles, and evidence-based use of different HER2-targeting agents when making individualized treatment
                                            recommendations for patients with HER2-positive breast cancer</span><label for="q6_1_1">Never<br>1</label></div>
                                      </td>
                                      <td headers="q6_header2" class="qiginput" id="yui_3_14_1_8_1640732973362_114"><input type="radio" name="q6_1" id="q6_1_2" value="2">
                                        <div class="confirmit-hidden"><label for="q6_1_2">Infrequently<br>2</label></div>
                                      </td>
                                      <td headers="q6_header3" class="qiginput" id="yui_3_14_1_8_1640732973362_119"><input type="radio" name="q6_1" id="q6_1_3" value="3">
                                        <div class="confirmit-hidden"><label for="q6_1_3">Sometimes<br>3</label></div>
                                      </td>
                                      <td headers="q6_header4" class="qiginput" id="yui_3_14_1_8_1640732973362_124"><input type="radio" name="q6_1" id="q6_1_4" value="4">
                                        <div class="confirmit-hidden"><label for="q6_1_4">Frequently<br>4</label></div>
                                      </td>
                                      <td headers="q6_header5" class="qiginput" id="yui_3_14_1_8_1640732973362_129"><input type="radio" name="q6_1" id="q6_1_5" value="5">
                                        <div class="confirmit-hidden"><label for="q6_1_5">Always<br>5</label></div>
                                      </td>
                                      <td headers="q6_header6" class="qiginput" id="yui_3_14_1_8_1640732973362_134"><input type="radio" name="q6_1" id="q6_1_6" value="6">
                                        <div class="confirmit-hidden"><label for="q6_1_6">N/A<br>&nbsp;</label></div>
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                                      <th class="qiggridlabel">Discuss the benefits and limitations different HER2-targeting therapies with patients with HER2-positive breast cancer</th>
                                      <td headers="q6_header1" class="qiginput" id="yui_3_14_1_8_1640732973362_139"><input type="radio" name="q6_2" id="q6_2_1" value="1">
                                        <div class="confirmit-hidden"><span>Discuss the benefits and limitations different HER2-targeting therapies with patients with HER2-positive breast cancer</span><label for="q6_2_1">Never<br>1</label></div>
                                      </td>
                                      <td headers="q6_header2" class="qiginput" id="yui_3_14_1_8_1640732973362_144"><input type="radio" name="q6_2" id="q6_2_2" value="2">
                                        <div class="confirmit-hidden"><label for="q6_2_2">Infrequently<br>2</label></div>
                                      </td>
                                      <td headers="q6_header3" class="qiginput" id="yui_3_14_1_8_1640732973362_149"><input type="radio" name="q6_2" id="q6_2_3" value="3">
                                        <div class="confirmit-hidden"><label for="q6_2_3">Sometimes<br>3</label></div>
                                      </td>
                                      <td headers="q6_header4" class="qiginput" id="yui_3_14_1_8_1640732973362_154"><input type="radio" name="q6_2" id="q6_2_4" value="4">
                                        <div class="confirmit-hidden"><label for="q6_2_4">Frequently<br>4</label></div>
                                      </td>
                                      <td headers="q6_header5" class="qiginput" id="yui_3_14_1_8_1640732973362_159"><input type="radio" name="q6_2" id="q6_2_5" value="5">
                                        <div class="confirmit-hidden"><label for="q6_2_5">Always<br>5</label></div>
                                      </td>
                                      <td headers="q6_header6" class="qiginput" id="yui_3_14_1_8_1640732973362_164"><input type="radio" name="q6_2" id="q6_2_6" value="6">
                                        <div class="confirmit-hidden"><label for="q6_2_6">N/A<br>&nbsp;</label></div>
                                      </td>
                                    </tr>
                                    <tr>
                                      <th class="qiggridlabel">Discuss enrollment in clinical trials evaluating rational HER2-targeting agents or combination or sequential approaches with patients with HER2-positive metastatic breast cancer,
                                        including patients in specific subgroups that have unmet needs (eg, patients with HER2-low status, HER2 mutations, brain metastases, among others)</th>
                                      <td headers="q6_header1" class="qiginput" id="yui_3_14_1_8_1640732973362_169"><input type="radio" name="q6_3" id="q6_3_1" value="1">
                                        <div class="confirmit-hidden"><span>Discuss enrollment in clinical trials evaluating rational HER2-targeting agents or combination or sequential approaches with patients with HER2-positive metastatic breast
                                            cancer, including patients in specific subgroups that have unmet needs (eg, patients with HER2-low status, HER2 mutations, brain metastases, among others)</span><label for="q6_3_1">Never<br>1</label></div>
                                      </td>
                                      <td headers="q6_header2" class="qiginput" id="yui_3_14_1_8_1640732973362_174"><input type="radio" name="q6_3" id="q6_3_2" value="2">
                                        <div class="confirmit-hidden"><label for="q6_3_2">Infrequently<br>2</label></div>
                                      </td>
                                      <td headers="q6_header3" class="qiginput" id="yui_3_14_1_8_1640732973362_179"><input type="radio" name="q6_3" id="q6_3_3" value="3">
                                        <div class="confirmit-hidden"><label for="q6_3_3">Sometimes<br>3</label></div>
                                      </td>
                                      <td headers="q6_header4" class="qiginput" id="yui_3_14_1_8_1640732973362_184"><input type="radio" name="q6_3" id="q6_3_4" value="4">
                                        <div class="confirmit-hidden"><label for="q6_3_4">Frequently<br>4</label></div>
                                      </td>
                                      <td headers="q6_header5" class="qiginput" id="yui_3_14_1_8_1640732973362_189"><input type="radio" name="q6_3" id="q6_3_5" value="5">
                                        <div class="confirmit-hidden"><label for="q6_3_5">Always<br>5</label></div>
                                      </td>
                                      <td headers="q6_header6" class="qiginput" id="yui_3_14_1_8_1640732973362_194"><input type="radio" name="q6_3" id="q6_3_6" value="6">
                                        <div class="confirmit-hidden"><label for="q6_3_6">N/A<br>&nbsp;</label></div>
                                      </td>
                                    </tr>
                                    <tr>
                                      <th class="qiggridlabel">Test patients with breast cancer for HER2 status (including HER2 low and HER2 mutations) to determine their candidacy for HER2-targeting therapies</th>
                                      <td headers="q6_header1" class="qiginput" id="yui_3_14_1_8_1640732973362_199"><input type="radio" name="q6_4" id="q6_4_1" value="1">
                                        <div class="confirmit-hidden"><span>Test patients with breast cancer for HER2 status (including HER2 low and HER2 mutations) to determine their candidacy for HER2-targeting therapies</span><label
                                            for="q6_4_1">Never<br>1</label></div>
                                      </td>
                                      <td headers="q6_header2" class="qiginput" id="yui_3_14_1_8_1640732973362_204"><input type="radio" name="q6_4" id="q6_4_2" value="2">
                                        <div class="confirmit-hidden"><label for="q6_4_2">Infrequently<br>2</label></div>
                                      </td>
                                      <td headers="q6_header3" class="qiginput" id="yui_3_14_1_8_1640732973362_209"><input type="radio" name="q6_4" id="q6_4_3" value="3">
                                        <div class="confirmit-hidden"><label for="q6_4_3">Sometimes<br>3</label></div>
                                      </td>
                                      <td headers="q6_header4" class="qiginput" id="yui_3_14_1_8_1640732973362_214"><input type="radio" name="q6_4" id="q6_4_4" value="4">
                                        <div class="confirmit-hidden"><label for="q6_4_4">Frequently<br>4</label></div>
                                      </td>
                                      <td headers="q6_header5" class="qiginput" id="yui_3_14_1_8_1640732973362_219"><input type="radio" name="q6_4" id="q6_4_5" value="5">
                                        <div class="confirmit-hidden"><label for="q6_4_5">Always<br>5</label></div>
                                      </td>
                                      <td headers="q6_header6" class="qiginput" id="yui_3_14_1_8_1640732973362_224"><input type="radio" name="q6_4" id="q6_4_6" value="6">
                                        <div class="confirmit-hidden"><label for="q6_4_6">N/A<br>&nbsp;</label></div>
                                      </td>
                                    </tr>
                                    <tr>
                                      <th class="qiggridlabel">Use dose escalation to manage diarrhea in patients with HER2-positive breast cancer who are being treated with neratinib</th>
                                      <td headers="q6_header1" class="qiginput" id="yui_3_14_1_8_1640732973362_229"><input type="radio" name="q6_5" id="q6_5_1" value="1">
                                        <div class="confirmit-hidden"><span>Use dose escalation to manage diarrhea in patients with HER2-positive breast cancer who are being treated with neratinib</span><label for="q6_5_1">Never<br>1</label></div>
                                      </td>
                                      <td headers="q6_header2" class="qiginput" id="yui_3_14_1_8_1640732973362_234"><input type="radio" name="q6_5" id="q6_5_2" value="2">
                                        <div class="confirmit-hidden"><label for="q6_5_2">Infrequently<br>2</label></div>
                                      </td>
                                      <td headers="q6_header3" class="qiginput" id="yui_3_14_1_8_1640732973362_239"><input type="radio" name="q6_5" id="q6_5_3" value="3">
                                        <div class="confirmit-hidden"><label for="q6_5_3">Sometimes<br>3</label></div>
                                      </td>
                                      <td headers="q6_header4" class="qiginput" id="yui_3_14_1_8_1640732973362_244"><input type="radio" name="q6_5" id="q6_5_4" value="4">
                                        <div class="confirmit-hidden"><label for="q6_5_4">Frequently<br>4</label></div>
                                      </td>
                                      <td headers="q6_header5" class="qiginput" id="yui_3_14_1_8_1640732973362_249"><input type="radio" name="q6_5" id="q6_5_5" value="5">
                                        <div class="confirmit-hidden"><label for="q6_5_5">Always<br>5</label></div>
                                      </td>
                                      <td headers="q6_header6" class="qiginput" id="yui_3_14_1_8_1640732973362_254"><input type="radio" name="q6_5" id="q6_5_6" value="6">
                                        <div class="confirmit-hidden"><label for="q6_5_6">N/A<br>&nbsp;</label></div>
                                      </td>
                                    </tr>
                                    <tr>
                                      <th class="qiggridlabel">Monitor patients with HER2-postive breast cancer being treated with different HER2-targeted therapies according to relevant warnings/precautions about potential adverse events</th>
                                      <td headers="q6_header1" class="qiginput" id="yui_3_14_1_8_1640732973362_259"><input type="radio" name="q6_6" id="q6_6_1" value="1">
                                        <div class="confirmit-hidden"><span>Monitor patients with HER2-postive breast cancer being treated with different HER2-targeted therapies according to relevant warnings/precautions about potential adverse
                                            events</span><label for="q6_6_1">Never<br>1</label></div>
                                      </td>
                                      <td headers="q6_header2" class="qiginput" id="yui_3_14_1_8_1640732973362_264"><input type="radio" name="q6_6" id="q6_6_2" value="2">
                                        <div class="confirmit-hidden"><label for="q6_6_2">Infrequently<br>2</label></div>
                                      </td>
                                      <td headers="q6_header3" class="qiginput" id="yui_3_14_1_8_1640732973362_269"><input type="radio" name="q6_6" id="q6_6_3" value="3">
                                        <div class="confirmit-hidden"><label for="q6_6_3">Sometimes<br>3</label></div>
                                      </td>
                                      <td headers="q6_header4" class="qiginput" id="yui_3_14_1_8_1640732973362_274"><input type="radio" name="q6_6" id="q6_6_4" value="4">
                                        <div class="confirmit-hidden"><label for="q6_6_4">Frequently<br>4</label></div>
                                      </td>
                                      <td headers="q6_header5" class="qiginput" id="yui_3_14_1_8_1640732973362_279"><input type="radio" name="q6_6" id="q6_6_5" value="5">
                                        <div class="confirmit-hidden"><label for="q6_6_5">Always<br>5</label></div>
                                      </td>
                                      <td headers="q6_header6" class="qiginput" id="yui_3_14_1_8_1640732973362_284"><input type="radio" name="q6_6" id="q6_6_6" value="6">
                                        <div class="confirmit-hidden"><label for="q6_6_6">N/A<br>&nbsp;</label></div>
                                      </td>
                                    </tr>
                                    <tr>
                                      <th class="qiggridlabel">Provide education, guidance, and resources to patients with HER2-positive breast cancer about HER2-targeted therapy, including efficacy and treatment-related adverse events associated
                                        with HER2-targeting therapies</th>
                                      <td headers="q6_header1" class="qiginput" id="yui_3_14_1_8_1640732973362_289"><input type="radio" name="q6_7" id="q6_7_1" value="1">
                                        <div class="confirmit-hidden"><span>Provide education, guidance, and resources to patients with HER2-positive breast cancer about HER2-targeted therapy, including efficacy and treatment-related adverse events
                                            associated with HER2-targeting therapies</span><label for="q6_7_1">Never<br>1</label></div>
                                      </td>
                                      <td headers="q6_header2" class="qiginput" id="yui_3_14_1_8_1640732973362_294"><input type="radio" name="q6_7" id="q6_7_2" value="2">
                                        <div class="confirmit-hidden"><label for="q6_7_2">Infrequently<br>2</label></div>
                                      </td>
                                      <td headers="q6_header3" class="qiginput" id="yui_3_14_1_8_1640732973362_299"><input type="radio" name="q6_7" id="q6_7_3" value="3">
                                        <div class="confirmit-hidden"><label for="q6_7_3">Sometimes<br>3</label></div>
                                      </td>
                                      <td headers="q6_header4" class="qiginput" id="yui_3_14_1_8_1640732973362_304"><input type="radio" name="q6_7" id="q6_7_4" value="4">
                                        <div class="confirmit-hidden"><label for="q6_7_4">Frequently<br>4</label></div>
                                      </td>
                                      <td headers="q6_header5" class="qiginput" id="yui_3_14_1_8_1640732973362_309"><input type="radio" name="q6_7" id="q6_7_5" value="5">
                                        <div class="confirmit-hidden"><label for="q6_7_5">Always<br>5</label></div>
                                      </td>
                                      <td headers="q6_header6" class="qiginput" id="yui_3_14_1_8_1640732973362_314"><input type="radio" name="q6_7" id="q6_7_6" value="6">
                                        <div class="confirmit-hidden"><label for="q6_7_6">N/A<br>&nbsp;</label></div>
                                      </td>
                                    </tr>
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Complete the survey for $25 USD

Knowledge/Competence Assessment and Educational Needs Survey
You have been selected to participate in a brief survey designed to assess the
current knowledge, competence, and educational needs of medical professionals
who are actively involved in the diagnosis and management of breast cancer.

In appreciation for completing this survey, you will receive a $25 USD
honorarium.

Questionnaire Length: 7 questions (approx. 10 minutes).





--------------------------------------------------------------------------------




1. Based on the current FDA approval, the novel HER2-targeted therapy tucatinib
is indicated for:

Patients with advanced unresectable or metastatic HER2-positive breast cancer
who have received no prior anti-HER2–based regimens in the metastatic setting
Patients with advanced unresectable or metastatic HER2-positive breast cancer,
except those with brain metastases, who have received 1 prior anti-HER2–based
regimen in the metastatic setting Patients with advanced unresectable or
metastatic HER2-positive breast cancer, including those with brain metastases,
who have received ≥1 prior anti-HER2–based regimen in the metastatic setting
Patients with advanced unresectable or metastatic HER2-positive breast cancer,
including those with brain metastases, who have received ≥2 prior
anti-HER2–based regimens in the metastatic setting I am not sure





--------------------------------------------------------------------------------




2. The phase 3 NALA trial, which evaluated the irreversible pan-HER tyrosine
kinase inhibitor neratinib plus capecitabine versus the reversible dual tyrosine
kinase inhibitor lapatinib plus capecitabine, has demonstrated significantly
prolonged PFS with neratinib plus capecitabine in which of the following patient
populations?

No benefit was observed in any of the patient populations in which the
combination was tested Patients with previously untreated metastatic
HER2-positive breast cancer Patients with metastatic HER2-positive breast cancer
that has progressed after 1 line of HER2-directed treatment Patients with
metastatic HER2-positive breast cancer that has progressed after at least 2
lines of HER2-directed treatment I’m not sure





--------------------------------------------------------------------------------




3. Your patient is a 55-year-old woman with HER2-postive metastatic breast
cancer who was previously treated with the combination of trastuzumab,
pertuzumab, and docetaxel in the first-line setting and trastuzumab emtansine in
the second-line setting. Ten months later, she develops a persistent headache,
and MRI reveals brain lesions with minimal edema. She is also found to have new
liver lesions. Which HER2-targeted therapy–based regimen would you recommend for
this patient?

Neratinib plus capecitabine Tucatinib plus trastuzumab and capecitabine
Margetuximab plus capecitabine Trastuzumab deruxtecan Continue on trastuzumab
emtansine I’m not sure





--------------------------------------------------------------------------------




4. You are managing a 50-year-old patient with HER2-overexpressed breast cancer
for whom you are considering treatment with the combination of neratinib and
capecitabine. She expresses concern about the potential for diarrhea as an
adverse effect of the therapy and is asking for guidance on preventive
approaches. Which of the following would you recommend as the best option for
reducing the potential for development of diarrhea in your patient?

I would give the patient loperamide 4 mg three times a day as prophylaxis for
the first two 4-week cycles and loperamide (≤16 mg/day) PRN after completion of
loperamide prophylaxis I would give the patient budesonide 9 mg daily in the
morning on days 1-28 of cycle 1 plus loperamide prophylaxis the first two 4-week
cycles I would give the patient colestipol 2 g orally twice daily for the first
cycle plus loperamide 4 mg three times a day as prophylaxis for the first two
4-week cycles and loperamide (≤16 mg/day) PRN after completion of loperamide
prophylaxis I would use the approach of escalating the doses of neratinib weekly
(120 mg/day on days 1-7, 160 mg/days on days 8-14, and 240 mg/day thereafter)
and give the patient loperamide (≤16 mg/day) PRN I’m not sure





--------------------------------------------------------------------------------




5. Your patient is a 58-year-old woman with HER2-positive metastatic breast
cancer who received first-line therapy with docetaxel, trastuzumab, and
pertuzumab, but 20 months later, she developed progression in the liver, with a
new 1-cm metastasis, as well as new lung metastases. Which of the following
would you recommend for your patient next, taking into account the latest
evidence and practice guidelines?

Trastuzumab emtansine Trastuzumab deruxtecan Neratinib + capecitabine Tucatinib
plus trastuzumab and capecitabine Margetuximab plus capecitabine I’m not sure





--------------------------------------------------------------------------------




6. How often do you currently do the following?

Never
1 Infrequently
2 Sometimes
3 Frequently
4 Always
5 N/A
  Consider the indications, unique characteristics and efficacy/safety profiles,
and evidence-based use of different HER2-targeting agents when making
individualized treatment recommendations for patients with HER2-positive breast
cancer
Consider the indications, unique characteristics and efficacy/safety profiles,
and evidence-based use of different HER2-targeting agents when making
individualized treatment recommendations for patients with HER2-positive breast
cancerNever
1
Infrequently
2
Sometimes
3
Frequently
4
Always
5
N/A
 
Discuss the benefits and limitations different HER2-targeting therapies with
patients with HER2-positive breast cancer
Discuss the benefits and limitations different HER2-targeting therapies with
patients with HER2-positive breast cancerNever
1
Infrequently
2
Sometimes
3
Frequently
4
Always
5
N/A
 
Discuss enrollment in clinical trials evaluating rational HER2-targeting agents
or combination or sequential approaches with patients with HER2-positive
metastatic breast cancer, including patients in specific subgroups that have
unmet needs (eg, patients with HER2-low status, HER2 mutations, brain
metastases, among others)
Discuss enrollment in clinical trials evaluating rational HER2-targeting agents
or combination or sequential approaches with patients with HER2-positive
metastatic breast cancer, including patients in specific subgroups that have
unmet needs (eg, patients with HER2-low status, HER2 mutations, brain
metastases, among others)Never
1
Infrequently
2
Sometimes
3
Frequently
4
Always
5
N/A
 
Test patients with breast cancer for HER2 status (including HER2 low and HER2
mutations) to determine their candidacy for HER2-targeting therapies
Test patients with breast cancer for HER2 status (including HER2 low and HER2
mutations) to determine their candidacy for HER2-targeting therapiesNever
1
Infrequently
2
Sometimes
3
Frequently
4
Always
5
N/A
 
Use dose escalation to manage diarrhea in patients with HER2-positive breast
cancer who are being treated with neratinib
Use dose escalation to manage diarrhea in patients with HER2-positive breast
cancer who are being treated with neratinibNever
1
Infrequently
2
Sometimes
3
Frequently
4
Always
5
N/A
 
Monitor patients with HER2-postive breast cancer being treated with different
HER2-targeted therapies according to relevant warnings/precautions about
potential adverse events
Monitor patients with HER2-postive breast cancer being treated with different
HER2-targeted therapies according to relevant warnings/precautions about
potential adverse eventsNever
1
Infrequently
2
Sometimes
3
Frequently
4
Always
5
N/A
 
Provide education, guidance, and resources to patients with HER2-positive breast
cancer about HER2-targeted therapy, including efficacy and treatment-related
adverse events associated with HER2-targeting therapies
Provide education, guidance, and resources to patients with HER2-positive breast
cancer about HER2-targeted therapy, including efficacy and treatment-related
adverse events associated with HER2-targeting therapiesNever
1
Infrequently
2
Sometimes
3
Frequently
4
Always
5
N/A
 






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7. Please submit at least one question, challenging case scenario, or barrier
related to breast cancer that you would like an expert in the field to address
as part of an upcoming educational activity:

Note: To receive your honorarium for participating in the survey, this field
must be completed.












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