Open AccessCurrent Treatment Approaches for Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer in Adjuvant and Neoadjuvant Settings
Author(s) -
Pankaj Goyal,
Dinesh Chandra Doval,
Chaturbhuj Agarwal,
Parveen Jain,
Krushna Chaudhari,
Kshitij Domadia,
Pallavi Redhu,
Venkata Pradeep Babu Koyyala,
Varun Goel,
Ullas Batra,
Vineet Talwar,
Sneha Bothra
Publication year - 2021
Publication title -
indian journal of medical and paediatric oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.229
H-Index - 22
eISSN - 0975-2129
pISSN - 0971-5851
DOI - 10.1055/s-0041-1729726
Subject(s) - lapatinib , pertuzumab , medicine , neratinib , trastuzumab emtansine , trastuzumab , oncology , breast cancer , human epidermal growth factor receptor 2 , adjuvant , cancer , targeted therapy , disease , adjuvant therapy , epidermal growth factor receptor , estrogen receptor
Breast cancer (BC) is the second most common cancer and the second leading cause of mortality among women globally. Approximately 20 to 25% of BC patients have amplification of the human epidermal growth factor receptor 2 (HER2) genes, a marker of poor prognosis. However, the introduction of anti-HER2-therapies (trastuzumab, followed closely by lapatinib, pertuzumab, trastuzumab emtansine, and neratinib) has changed the natural history of HER2-positive BC and improved the outcome in HER2-positive BC patients. The preeminence of anti-HER2 combination therapy in achieving complete inhibition of the various HER receptor dimers has been demonstrated in clinical studies. However, despite these therapeutic advances, tumors expressing estrogen receptor have poorer responses to targeted therapy and are more likely to relapse. A better understanding of resistance to existing anti-HER2 agents, along with the role played by the microenvironment and of interconnected signaling pathways, can permit tailor-made therapeutic options for each patient. This review aimed to evaluate treatment approaches for BC patients with HER2-positive disease in the adjuvant and neoadjuvant settings, also exploring the possibilities of extended duration of anti-HER2 maintenance therapy.