Appropriate Treatment for Patients with Stage I (T1c) – III HER2 Positive

Measure Specification

Approximately 10-20 percent of patients with breast cancer have tumors that overexpress the human epidermal growth factor receptor (HER2) protein (Early Breast Cancer Trialists' Collaborative group (EBCTCG), 2021). High levels of the HER2 protein are linked with a higher likelihood of metastasis, increased risk of disease recurrence, and a decrease in patient survival, but are more likely to respond to targeted therapies (Early Breast Cancer Trialists' Collaborative group (EBCTCG), 2021) &.

Numerous adjuvant trials of trastuzumab have demonstrated clinically significant improvements in disease-free survival, with the HERA, NSABP B31, and NCCTGF N9831 trials also demonstrating significant improvement in overall survival with the use of trastuzumab. The benefits of trastuzumab are independent of estrogen receptor (ER) status. The American Society of Clinical Oncology (ASCO) envisions that use of this measure will improve concordance with recommendations for the use of HER2-targeted therapy with chemotherapy for patients with stage I (T1c) – III, HER2 positive breast cancer.

NCCN Recommendation for Adjuvant HER2-Targeted Therapy The panel recommends HER2-targeted therapy in patients with HER2-positive tumors. The panel has designated use of trastuzumab with chemotherapy as a category 1 recommendation for all HER2 positive tumors >1cm (Gradishar, Moran, Abraham, & al., 2024).

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this patient-process measure is submitted a minimum of once per patient during the performance period.