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Trastuzumab in the Treatment of Breast Cancer
Sofia Maximiano1, Paulo Magalhães1,2,3,4, Mara Pereira Guerreiro5,6
1CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Av. Infante D. Henrique, Covilhã, Portugal.
Abstract:
Breast cancer (BC) is the most common cancer in women worldwide, and has an undeniable negative impact on public health. The advent of molecular biology and immunotherapy has made targeted therapeutic interventions possible, providing treatments tailored to the individual characteristics of the patient and the disease. The over-expression of human epidermal growth factor receptor (HER) 2 is implicated in the pathophysiology of BC and represents a clinically relevant biomarker for its treatment. Trastuzumab, a recombinant antibody targeting HER2, was the first biological drug approved for the treatment of HER2-positive BC. Although there are currently other anti-HER2 agents available (e.g. pertuzumab and lapatinib), trastuzumab remains the gold standard for treatment of this disease subtype. Nonetheless, concerns have been raised regarding potential cardiotoxicity and treatment resistance. Moreover, several other therapeutic issues remain unclear and have been addressed in an inconsistent way. The current literature lacks a comprehensive review of trastuzumab providing useful information for clinical practice, including pharmacokinetic and pharmacodynamic aspects, its clinical use, existing controversies and future advances. This detailed review of trastuzumab in the pharmacotherapy of BC attempts to fill this gap.
Insights
Trastuzumab is a key treatment for HER2-positive breast cancer (BC), but concerns about cardiotoxicity and resistance exist. This review covers its use, pharmacokinetics, and future directions for BC therapy.
Area of Science:
- Oncology
- Pharmacology
- Molecular Biology
Background:
- Breast cancer (BC) is a leading global health concern, particularly in women.
- Human epidermal growth factor receptor 2 (HER2) overexpression is crucial in BC development and treatment selection.
- Trastuzumab, an anti-HER2 antibody, is a cornerstone therapy for HER2-positive BC.
Purpose of the Study:
- To provide a comprehensive review of trastuzumab in breast cancer pharmacotherapy.
- To address current gaps in clinical understanding regarding trastuzumab's use.
- To consolidate information on pharmacokinetics, pharmacodynamics, clinical applications, controversies, and future prospects.
Main Methods:
- Literature review of scientific publications on trastuzumab and HER2-positive breast cancer.
- Analysis of pharmacokinetic and pharmacodynamic data.
- Synthesis of information on clinical efficacy, safety, and resistance mechanisms.
Main Results:
- Trastuzumab remains the gold standard for HER2-positive BC despite emerging agents.
- Potential cardiotoxicity and treatment resistance are significant clinical challenges.
- Inconsistent management of therapeutic issues necessitates further clarification.
Conclusions:
- A comprehensive understanding of trastuzumab is vital for optimizing clinical practice in HER2-positive BC.
- Further research is needed to address safety concerns and overcome resistance.
- This review aims to guide clinicians by consolidating current knowledge and highlighting future research avenues.
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