Clinical updates on EGFR/HER targeted agents in early-stage breast cancer

Recent updated reports from the large adjuvant trials in HER2-positive breast cancer indicate that the remarkable benefits of adding trastuzumab to chemotherapy appear, so far, to be sustained rather than transient. Other studies show that even small, node-negative, HER2-positive tumors carry some risk of recurrence and might benefit from trastuzumab-based adjuvant therapy. Evaluations of HER2 test results have examined the benefit of trastuzumab in cancers that exhibit focally positive gene amplification and also have raised the question of whether the criteria that correlate HER2 positivity with trastuzumab benefit in the adjuvant setting may be different from the criteria that apply in the treatment of metastatic disease. New results from trials combining targeted agents in the treatment of metastatic breast cancer provide strong rationale for the current adjuvant trials. In addition, neoadjuvant studies lend further support for combining targeted agents and may also provide an optimal setting to identify biomarkers that correlate with patient outcome. A new generation of therapies, including novel targeted agents and vaccines, is moving forward in clinical development and will be incorporated into adjuvant regimens in the future.