A new retrospective cohort study highlights that, despite major advances in breast cancer treatment, one in four women with metastatic HER2-positive, hormone receptor-negative breast cancer is not receiving recommended HER2-targeted therapies. These treatments, which have transformed HER2-positive breast cancer into one of the most treatable forms of the disease, are proven to significantly improve survival—yet access remains uneven.
Key Findings
- Study Details: Researchers analyzed data from over 3,000 women diagnosed between 2013 and 2020. While the use of HER2-targeted therapies rose quickly from 65% in 2013 to 81% in 2016, it has since plateaued at about 76%—meaning nearly a quarter of eligible patients are not receiving these life-extending drugs.
- Survival Impact: Patients who received HER2-targeted therapy lived much longer (median survival of 5.08 years) compared to those who did not (1.27 years). The risk of death was nearly 50% lower for those who received the therapy.
- Barriers to Access: Several factors were linked to a lower chance of receiving HER2-targeted treatment:
- Age 71 or older
- Black race
- Medicare insurance
- Treatment at rural facilities
- Positive Factors: Patients were more likely to receive HER2-targeted therapy if they:
- Had private insurance
- Were treated at academic centers
- Were diagnosed in more recent years
Why This Matters
Experts stress that the goal should be near-universal access to HER2-targeted therapies for all eligible patients, as these drugs can extend survival by years. The current 24% gap is not just a statistic—it represents thousands of women missing out on proven, guideline-recommended care.
What Can Be Done?
Doctors and advocates are calling for:
- Proactive patient navigation and financial counseling to help patients overcome insurance and cost barriers.
- Wider use of lower-cost biosimilars to make treatment more affordable.
- Increased support for rural and under-resourced hospitals to ensure all patients have access to the latest therapies.
While new drugs and awareness are helping, older patients and those in rural areas still face the greatest challenges. Experts urge ongoing efforts to close these gaps so that every woman with HER2-positive breast cancer can benefit from the latest advances in care.
If you or a loved one is facing metastatic HER2-positive breast cancer, talk to your care team about all available treatment options and support resources. Access to the right therapy can make a life-changing difference.
More Reading
Understanding HER2 positive Breast Cancer and its Treatment
Join the conversation on Cancer Connect.
Reference
Ajjawi I, Rios A, Wei W, Park TS, Lustberg MB. Clinical, Sociodemographic, and Facility-Related Factors Influencing HER2-Targeted Therapy in Metastatic Hormone Receptor-Negative, HER2-Positive Breast Cancer. Cancers (Basel). 2025 May 6;17(9):1579.
