Treatment of HER2-positive breast cancer

Maria Cristina Figueroa-Magalhães, Danijela Jelovac, Roisin Connolly, Antonio C Wolff

Research output: Contribution to journalArticle

Abstract

The human epidermal growth factor receptor 2 gene (HER2) is overexpressed and/or amplified in ~15% of breast cancer patients and was identified a quarter century ago as a marker of poor prognosis. By 1998, antibody therapy targeting the HER2 pathway was shown to demonstrably improve progression-free and overall survival in metastatic disease, and in 2005 evidence of improvement in disease-free and overall survival from the first generation of trastuzumab adjuvant trials became available. However, not all patients with HER2 overexpression benefit from trastuzumab. Second-generation studies in metastatic disease led to the approval of several new HER2-targeted therapies using small molecule tyrosine kinase inhibitors such as lapatinib, new HER2/HER3 antibodies such as pertuzumab, and the new antibody chemotherapy conjugate ado-trastuzumab emtansine. These successes supported the launch of second-generation adjuvant trials testing single and dual HER2-targeted agents, administered concomitantly or sequentially with chemotherapy that will soon complete accrual. HER2-positive breast cancer in the setting of HER2-targeted therapy is no longer associated with poor prognosis, and recent guidance by the US Food and Drug Administration suggests that pathologic response to HER2-targeted therapy given preoperatively may allow an earlier assessment of their clinical benefit in the adjuvant setting. An adjuvant trial of trastuzumab in patient whose tumors express normal levels of HER2 and trials of single/dual HER2-targeting without chemotherapy are also ongoing. In this article, we review the current data on the therapeutic management of HER2-positive breast cancer.

Original languageEnglish (US)
Pages (from-to)128-136
Number of pages9
JournalBreast
Volume23
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Breast Neoplasms
Drug Therapy
Disease-Free Survival
Antibodies
erbB-1 Genes
Therapeutics
United States Food and Drug Administration
Protein-Tyrosine Kinases
Trastuzumab
Neoplasms

Keywords

  • HER2-positive breast cancer
  • Lapatinib
  • Pertuzumab
  • Trastuzumab

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Treatment of HER2-positive breast cancer. / Figueroa-Magalhães, Maria Cristina; Jelovac, Danijela; Connolly, Roisin; Wolff, Antonio C.

In: Breast, Vol. 23, No. 2, 2014, p. 128-136.

Research output: Contribution to journalArticle

Figueroa-Magalhães, MC, Jelovac, D, Connolly, R & Wolff, AC 2014, 'Treatment of HER2-positive breast cancer', Breast, vol. 23, no. 2, pp. 128-136. https://doi.org/10.1016/j.breast.2013.11.011
Figueroa-Magalhães, Maria Cristina ; Jelovac, Danijela ; Connolly, Roisin ; Wolff, Antonio C. / Treatment of HER2-positive breast cancer. In: Breast. 2014 ; Vol. 23, No. 2. pp. 128-136.
@article{669a3a9f84314983b2bc7bcdeac3c2f9,
title = "Treatment of HER2-positive breast cancer",
abstract = "The human epidermal growth factor receptor 2 gene (HER2) is overexpressed and/or amplified in ~15{\%} of breast cancer patients and was identified a quarter century ago as a marker of poor prognosis. By 1998, antibody therapy targeting the HER2 pathway was shown to demonstrably improve progression-free and overall survival in metastatic disease, and in 2005 evidence of improvement in disease-free and overall survival from the first generation of trastuzumab adjuvant trials became available. However, not all patients with HER2 overexpression benefit from trastuzumab. Second-generation studies in metastatic disease led to the approval of several new HER2-targeted therapies using small molecule tyrosine kinase inhibitors such as lapatinib, new HER2/HER3 antibodies such as pertuzumab, and the new antibody chemotherapy conjugate ado-trastuzumab emtansine. These successes supported the launch of second-generation adjuvant trials testing single and dual HER2-targeted agents, administered concomitantly or sequentially with chemotherapy that will soon complete accrual. HER2-positive breast cancer in the setting of HER2-targeted therapy is no longer associated with poor prognosis, and recent guidance by the US Food and Drug Administration suggests that pathologic response to HER2-targeted therapy given preoperatively may allow an earlier assessment of their clinical benefit in the adjuvant setting. An adjuvant trial of trastuzumab in patient whose tumors express normal levels of HER2 and trials of single/dual HER2-targeting without chemotherapy are also ongoing. In this article, we review the current data on the therapeutic management of HER2-positive breast cancer.",
keywords = "HER2-positive breast cancer, Lapatinib, Pertuzumab, Trastuzumab",
author = "Figueroa-Magalh{\~a}es, {Maria Cristina} and Danijela Jelovac and Roisin Connolly and Wolff, {Antonio C}",
year = "2014",
doi = "10.1016/j.breast.2013.11.011",
language = "English (US)",
volume = "23",
pages = "128--136",
journal = "Breast",
issn = "0960-9776",
publisher = "Churchill Livingstone",
number = "2",

}

TY - JOUR

T1 - Treatment of HER2-positive breast cancer

AU - Figueroa-Magalhães, Maria Cristina

AU - Jelovac, Danijela

AU - Connolly, Roisin

AU - Wolff, Antonio C

PY - 2014

Y1 - 2014

N2 - The human epidermal growth factor receptor 2 gene (HER2) is overexpressed and/or amplified in ~15% of breast cancer patients and was identified a quarter century ago as a marker of poor prognosis. By 1998, antibody therapy targeting the HER2 pathway was shown to demonstrably improve progression-free and overall survival in metastatic disease, and in 2005 evidence of improvement in disease-free and overall survival from the first generation of trastuzumab adjuvant trials became available. However, not all patients with HER2 overexpression benefit from trastuzumab. Second-generation studies in metastatic disease led to the approval of several new HER2-targeted therapies using small molecule tyrosine kinase inhibitors such as lapatinib, new HER2/HER3 antibodies such as pertuzumab, and the new antibody chemotherapy conjugate ado-trastuzumab emtansine. These successes supported the launch of second-generation adjuvant trials testing single and dual HER2-targeted agents, administered concomitantly or sequentially with chemotherapy that will soon complete accrual. HER2-positive breast cancer in the setting of HER2-targeted therapy is no longer associated with poor prognosis, and recent guidance by the US Food and Drug Administration suggests that pathologic response to HER2-targeted therapy given preoperatively may allow an earlier assessment of their clinical benefit in the adjuvant setting. An adjuvant trial of trastuzumab in patient whose tumors express normal levels of HER2 and trials of single/dual HER2-targeting without chemotherapy are also ongoing. In this article, we review the current data on the therapeutic management of HER2-positive breast cancer.

AB - The human epidermal growth factor receptor 2 gene (HER2) is overexpressed and/or amplified in ~15% of breast cancer patients and was identified a quarter century ago as a marker of poor prognosis. By 1998, antibody therapy targeting the HER2 pathway was shown to demonstrably improve progression-free and overall survival in metastatic disease, and in 2005 evidence of improvement in disease-free and overall survival from the first generation of trastuzumab adjuvant trials became available. However, not all patients with HER2 overexpression benefit from trastuzumab. Second-generation studies in metastatic disease led to the approval of several new HER2-targeted therapies using small molecule tyrosine kinase inhibitors such as lapatinib, new HER2/HER3 antibodies such as pertuzumab, and the new antibody chemotherapy conjugate ado-trastuzumab emtansine. These successes supported the launch of second-generation adjuvant trials testing single and dual HER2-targeted agents, administered concomitantly or sequentially with chemotherapy that will soon complete accrual. HER2-positive breast cancer in the setting of HER2-targeted therapy is no longer associated with poor prognosis, and recent guidance by the US Food and Drug Administration suggests that pathologic response to HER2-targeted therapy given preoperatively may allow an earlier assessment of their clinical benefit in the adjuvant setting. An adjuvant trial of trastuzumab in patient whose tumors express normal levels of HER2 and trials of single/dual HER2-targeting without chemotherapy are also ongoing. In this article, we review the current data on the therapeutic management of HER2-positive breast cancer.

KW - HER2-positive breast cancer

KW - Lapatinib

KW - Pertuzumab

KW - Trastuzumab

UR - http://www.scopus.com/inward/record.url?scp=84895429279&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895429279&partnerID=8YFLogxK

U2 - 10.1016/j.breast.2013.11.011

DO - 10.1016/j.breast.2013.11.011

M3 - Article

VL - 23

SP - 128

EP - 136

JO - Breast

JF - Breast

SN - 0960-9776

IS - 2

ER -