The adjuvant treatment of HER2-positive breast cancer

Research output: Contribution to journalArticlepeer-review

Abstract

About 15-20% of patients with early stage breast cancer present with tumors that have overexpression or amplification of the human epidermal growth factor receptor 2 (HER2) gene. Before 2005, these individuals had an increased risk of recurrence and death, but since then their outcomes have substantially improved with the adoption in most countries of adjuvant trastuzumab as a standard component of therapy for HER2-positive early-stage breast cancer. Consequently, access to high-quality and accurate HER2 testing methods is critical to accurately determine HER2 status, guide treatment decisions, and ultimately improve clinical outcomes. In 2012, the humanized monoclonal anti-HER antibody trastuzumab was the only approved HER2-Targeted therapy in the adjuvant setting. Data from the first generation of trials combining it with various chemotherapy regimens showed significant improvements in disease-free and overall survival (DFS/OS). Based on results from five randomized clinical trials, a trastuzumab-containing regimen for up to 1 year is now considered standard for all patients with HER2-positive tumors larger than 1 cm in size who would have fulfilled eligibility to those studies, and this recommendation is sometimes extended to patients with stage tumors greater than 0.5 cm (T1b). Second generation adjuvant studies with other HER2-Targeted agents like lapatinib and pertuzumab are ongoing, and newer drugs like T-DM1 and neratinib are being actively tested in the metastatic setting.

Original languageEnglish (US)
Pages (from-to)230-239
Number of pages10
JournalCurrent treatment options in oncology
Volume13
Issue number2
DOIs
StatePublished - Jun 2012

Keywords

  • Adjuvant treatment
  • Breast cancer
  • HER2-positive breast cancer
  • Trastuzumab
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)

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