Can Podcasts Help Improve Adoption of HER2-Low Therapies?
Expert Perspectives · Keira Smith · 2026-06-09
In community oncology, human epidermal growth factor receptor 2 (HER2) testing is largely routine, but translating nuanced HER2 results into the right therapy is a newer challenge. At the 2026 ISPOR Annual Meeting, Dr. Jessica Paulus presented research on how targeted education, embedded directly into clinical workflows, can improve real-world adoption of HER2-low therapies for metastatic breast cancer.
Real-World Data From Community Practice
As Vice President of Real-World Research at Ontada, Dr. Paulus leads scientific teams that generate real-world evidence using data derived directly from community oncology practices across the US Oncology Network. She emphasizes what that enables: “we are both the originator of the data, and we also are embedded within the care delivery system.” This positioning makes it possible not only to study practice patterns, but also to engage clinicians directly, observe changes over time, and provide feedback to clinicians about their practice.
Implications of HER2-Low in Breast Cancer
Dr. Paulus underscores that HER2 testing itself is well-established: “for the oncology community, it’s well-known how important HER2 testing is for all newly diagnosed breast cancer patients.” What’s changed is the clinical meaning of borderline results. “What’s changed more recently is the recognition of HER2-low disease as a distinct and clinically meaningful category,” she says, pointing to “new therapies recently available for patients with metastatic disease who are in this HER2-low category.”
This shift requires more precision than the historical binary: “this is no longer just a binary positive or negative distinction, like high or low HER2, rather we’re thinking about more granular levels of HER2 level testing results.” The risk is practical: “these differences in how the results are interpreted and how they’re documented can really affect whether a patient is eligible for a therapy that could meaningfully improve their outcome.” While HER2 testing has a solid role in practice, interpretation and treatment alignment are “a little bit uncharted.”
Designing a Real-World Study
The study conducted by Dr. Paulus and her team asked whether evolving HER2-low guidelines were being applied consistently and whether targeted education could help. The team ran an observational study using secondary use of electronic health record data from community-treated metastatic breast cancer patients.
The integrated design had three phases: a baseline assessment of HER2 testing and treatment patterns, implementation of educational initiatives, and a reevaluation of treatment patterns. The education was intentionally accessible: “it included podcasts and electronic health record (EHR)–based on-demand consultations, which were almost like a phone-a-friend consult with a peer.”
How Concordance Improved
Results matched expectations on testing: “we saw a 95% or higher documentation of testing of HER2.” The more revealing metric was treatment alignment: at baseline, receipt of guideline-concordant therapy was 62%. After the initiatives, the improvement was notable, with rates improving from 62% to 71%. Importantly, the gains tracked with participation: the boost “was restricted to the patients who were seen by the physicians who received the educational training.”
Bridging the Gap Between Guidelines and Practice
Dr. Paulus argues that real-world data helps pinpoint gaps quickly between recommendations and what’s actually happening in real-time clinical practice. New paradigms aren’t adopted automatically—there’s typically some degree of lag. Their findings suggest that targeted and accessible education packages, delivered directly to practicing oncologists, can be very effective. Seeing the effect of education is motivational: “what really gets us out of bed is the ability to have that knowledge, to feed it back to the bedside, and then to change care.”
Implementing Education Into Practice
Dr. Paulus highlights a promising opportunity even in mature testing areas: “everybody’s doing HER2 testing, yet there can still be meaningful gaps in how the results are translated into treatment decisions.” She reiterates that “targeted educational initiatives can really improve guideline-concordant care” and that real-world data can be used “not just to passively observe or document the gaps but to measure the impact” of closing them, integrating quality education with quantitative research.
Conclusion
Dr. Paulus’s central message is the importance of “highlighting the value of integrating data with provider engagement to accelerate the adoption of these rapidly evolving standards of care.” With major oncology meetings driving rapid change, she calls it “a real opportunity to think about how we can effectively use real-world data to drive the adoption of these evolving standards of care.”
Key Takeaways
HER2 testing may be widespread, but HER2-low status demands granular interpretation and documentation.
Embedding education into workflows can shift care patterns quickly.
In this study, guideline-concordant care increased from 62% to 71% among clinicians who engaged with the education.
A quality improvement process embedded in a real-world data ecosystem can help close guideline-to-practice gaps.
The model links insight to action, using real-world data to continuously improve care in a learning health cycle
About Dr. Paulus
Jessica Paulus, ScD, is the Vice President of Real-World Research at Ontada. She leads a team of scientists with expertise in leveraging real-world data networks to meaningfully inform clinical and regulatory decision making, and she provides scientific oversight to study design, analytic approaches, and dissemination strategies for real-world data—based studies.