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Review
. 2023 Jan 30:13:1066007.
doi: 10.3389/fonc.2023.1066007. eCollection 2023.

Review of the status of neoadjuvant therapy in HER2-positive breast cancer

Gavin P Dowling  1   2   3 , Stephen Keelan  2   3 , Sinead Toomey  1 , Gordon R Daly  2   3 , Bryan T Hennessy  1 , Arnold D K Hill  2   3
Affiliations
Review

Review of the status of neoadjuvant therapy in HER2-positive breast cancer

Gavin P Dowling et al. Front Oncol. .

Abstract

Purpose: The development of human epidermal growth factor receptor 2 (HER2)-directed therapies has revolutionized the treatment of HER2-positive breast cancer. The aim of this article is to review the continually evolving treatment strategies in the neoadjuvant setting of HER2-positive breast cancer, as well as the current challenges and future perspectives.

Methods: Searches were undertaken on PubMed and Clinicaltrials.gov for relevant publications and trials.

Findings: The current standard of care in high-risk HER2-positive breast cancer is to combine chemotherapy with dual anti-HER2 therapy, for a synergistic anti-tumor effect. We discuss the pivotal trials which led to the adoption of this approach, as well as the benefit of these neoadjuvant strategies for guiding appropriate adjuvant therapy. De-escalation strategies are currently being investigated to avoid over treatment, and aim to safely reduce chemotherapy, while optimizing HER2-targeted therapies. The development and validation of a reliable biomarker is essential to enable these de-escalation strategies and personalization of treatment. In addition, promising novel therapies are currently being explored to further improve outcomes in HER2-positive breast cancer.

Keywords: HER2 (human epidermal growth factor 2); antibody-drug-conjugates; biomarker; breast cancer; neoadjuvant therapy; targeted therapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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