Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jul 28;12(8):2081.
doi: 10.3390/cancers12082081.

The Changing Paradigm for the Treatment of HER2-Positive Breast Cancer

Aena Patel  1 , Nisha Unni  1 , Yan Peng  2
Affiliations
Review

The Changing Paradigm for the Treatment of HER2-Positive Breast Cancer

Aena Patel et al. Cancers (Basel). .

Abstract

For decades, HER2-positive breast cancer was associated with poor outcomes and higher mortality rates than other breast cancer subtypes. However, the advent of Trastuzumab (Herceptin) has significantly changed the treatment paradigm of patients afflicted with HER2-positive breast cancer. The discovery of newer HER2-targeted therapies, such as Pertuzumab (Perjeta), has further added to the armamentarium of treating HER2-positive breast cancers. This review highlights recent advancements in the treatment of HER2-positive diseases, including the newer HER2-targeted therapies and immunotherapies in clinical trials, which have paved (and will further update) the way for clinical practice, and become part of the standard of care in the neoadjuvant, adjuvant or metastatic setting.

Keywords: HER2-positive breast cancer; immunotherapy; metastatic disease; neoadjuvant and adjuvant therapy; targeted therapy.

PubMed Disclaimer

Conflict of interest statement

Nisha Unni declares is serving on the advisory board of Eisai Inc. The other authors do not have a conflict of interest.

Figures

Figure 1
Figure 1
HER2 signaling pathway, mechanism of action of targeted therapies, and resistance mechanisms. 1. The truncated P95HER2 isoform results in the loss of the extracellular binding site for trastuzumab. 2.–3. Overexpression of other tyrosine kinase receptors, such as IGF1-R and C-met, can continue to trigger downstream signaling despite blockade by trastuzumab. 4. Mutations or loss of PTEN constitutively activates the PI3K signaling pathway.
See this image and copyright information in PMC

References

    1. Howlader N., Cronin K.A., Kurian A.W., Andridge R. Differences in Breast Cancer Survival by Molecular Subtypes in the United States. Cancer Epidemiol. Biomark. Prev. 2018;27:619–626. doi: 10.1158/1055-9965.EPI-17-0627. - DOI - PubMed
    1. Slamon D.J., Clark G.M., Wong S.G., Levin W.J., Ullrich A., McGuire W.L. Human breast cancer: Correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235:177–182. doi: 10.1126/science.3798106. - DOI - PubMed
    1. Slamon D.J., Leyland-Jones B., Shak S., Fuchs H., Paton V., Baiamonde A., Fleming T., Eiermann W., Wolter J., Pegram M., et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N. Engl. J. Med. 2001;344:783–792. doi: 10.1056/NEJM200103153441101. - DOI - PubMed
    1. Browne B.C., O’Brien N., Duffy M.J., Crown J., O’Donovan N. Her-2 signaling and inhibition in breast cancer. Curr. Cancer Drug Targets. 2009;9:419–438. doi: 10.2174/156800909788166484. - DOI - PubMed
    1. Fehrenbacher L., Cecchini R.S., Geyer C.E., Rastogi P., Costantino J., Atkins J.N., Crown J.P., Polikoff J., Boileau J.F., Provencher L., et al. NSABP B-47/NRG Oncology Phase III Randomized Trial Comparing Adjuvant Chemotherapy With or Without Trastuzumab in High-Risk Invasive Breast Cancer Negative for HER2 by FISH and With IHC 1+ or 2. J. Clin. Oncol. 2020;38:444. doi: 10.1200/JCO.19.01455. - DOI - PMC - PubMed