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HER-2-positive metastatic breast cancer: trastuzumab and beyond

Giulio Metro1, Marcella Mottolese, Alessandra Fabi

  • 1Regina Elena Cancer Institute, Division of Medical Oncology A, Via Elio Chianesi, 53, 00144 Rome, Italy.

Expert Opinion on Pharmacotherapy
|September 23, 2008
PubMed
Abstract

Insights

Human epidermal growth factor receptor 2 (HER2)-targeted therapies, including trastuzumab, are standard for HER2-positive breast cancer. New options like lapatinib and future chemotherapy-free combinations offer hope for patients progressing on trastuzumab.

Area of Science:

  • Oncology
  • Pharmacology
  • Molecular Biology

Background:

  • Human epidermal growth factor receptor 2 (HER2) emerged as a key therapeutic target for breast cancer in the late 1980s.
  • This led to the development of targeted therapies for HER2-overexpressing breast tumors.

Purpose of the Study:

  • To review the standard treatment for HER2-positive metastatic breast cancer, primarily trastuzumab-based therapies.
  • To explore emerging treatment options for patients who progress on trastuzumab.

Main Methods:

  • Comprehensive literature search covering trastuzumab development to novel biologic agents.
  • Review of clinical data on treatments for HER2-positive disease.

Main Results:

  • Trastuzumab plus taxane is a primary therapy for HER2-positive metastatic breast cancer.
  • Lapatinib combined with capecitabine is approved for patients progressing on trastuzumab.
  • Future strategies include chemotherapy-free combinations with trastuzumab and other HER2-targeting agents for refractory patients.

Conclusions:

  • Trastuzumab remains a cornerstone in HER2-positive metastatic breast cancer treatment.
  • Advancements in targeted therapies, including dual inhibitors and novel biologic combinations, are expanding treatment paradigms.
  • Chemotherapy-free approaches are being investigated for trastuzumab-refractory disease.

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