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HER2-Orientated Therapy in Early and Metastatic Breast Cancer
Severine Iborra1, Elmar Stickeler1
1Department of Gynecology and Obstetrics, University Medical Center Aachen, Aachen, Germany.
Abstract:
Due to the enhanced understanding of molecular oncology and signaling pathways in breast cancer (BC), therapy management has undergone a major transformation, especially with the emergence of treatment tailored to individual disease characteristics. In the case of HER2-positive early or metastatic BC, targeted therapies are well established and remain a major focus of ongoing research. The introduction of anti-HER2 biologicals such as trastuzumab, pertuzumab, and T-DM1 has made targeted and personalized treatment possible and has clearly improved disease-free and overall survival in patients with HER2-positive BC. Moreover, neoadjuvant chemotherapy represents a well-established and often favored option for patients with operable BC and a clear indication for postoperative chemotherapy (such as HER2-positive BC). Other trials are trying to identify additional surrogate markers for therapy response and clinical outcome in the neoadjuvant setting and that way open up new perspectives with a possible de-escalation of classical treatment in favor of targeted therapy.
Insights
Personalized medicine transforms breast cancer (BC) therapy, especially for HER2-positive cases. Targeted therapies like trastuzumab improve survival, with ongoing research exploring new markers for treatment de-escalation.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Advances in molecular oncology and signaling pathways have revolutionized breast cancer (BC) treatment.
- Personalized medicine, tailored to individual disease characteristics, is increasingly central to BC therapy management.
Purpose of the Study:
- To review the impact of targeted therapies on HER2-positive early or metastatic breast cancer.
- To discuss the role of neoadjuvant chemotherapy and the search for novel surrogate markers in BC treatment.
Main Methods:
- Review of established and emerging targeted therapies for HER2-positive BC.
- Analysis of the role of neoadjuvant chemotherapy in operable BC.
- Exploration of research into surrogate markers for therapy response.
Main Results:
- Anti-HER2 biologicals (trastuzumab, pertuzumab, T-DM1) have enabled personalized treatment and improved survival for HER2-positive BC patients.
- Neoadjuvant chemotherapy is a standard option for operable BC requiring postoperative treatment.
- Research is identifying new markers to guide neoadjuvant therapy and potentially de-escalate conventional treatments.
Conclusions:
- Targeted therapies have significantly advanced the treatment of HER2-positive breast cancer.
- Future research aims to refine neoadjuvant strategies through personalized marker identification, potentially leading to treatment de-escalation.
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