HER2-positive metastatic breast cancer: a changing scenario.

Abstract

Adjuvant trastuzumab (AT) dramatically improved HER2-positive breast cancer prognosis. Relapsed disease after AT has different patterns and information is available from observational studies. In this Review Chemotherapy regimens combined to anti-HER2 blockade are discussed, focusing in particular the role of anthracyclines, taxanes and capecitabine. The use of trastuzumab beyond progression and the role of other anti-HER2 agents like lapatinib, pertuzumab and T-DM1 are explored, as also dual blockade and in trastuzumab resistant Patients. Metastatic "de novo" HER2 Luminal (co-expression of HER2 and hormone receptors) Patients are eligible for anastrozole and trastuzumab but if pretreated with trastuzumab they are also eligible for lapatinib and letrozole. In any case endocrine treatment plays a complementary role to chemotherapy which remains pivotal. The last topic explored is treatment options for patients with brain metastases where both trastuzumab given concurrent with radiotherapy or lapatinib and capecitabine appear as potentially active.

• Authors: G Mustacchi, L Biganzoli, P Pronzato, F Montemurro, M Dambrosio, M Minelli, L Molteni, L Scaltriti
• Journal: Critical reviews in oncology/hematology (Crit Rev Oncol Hematol) Vol. 95 Issue 1 Pg. 78-87 (Jul 2015) ISSN: 1879-0461 [Electronic] Netherlands
• PMID: 25748080 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Anthracyclines
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Quinazolines
• Taxoids
• Lapatinib
• Maytansine
• Capecitabine
• Receptor, ErbB-2
• pertuzumab
• Trastuzumab
• Ado-Trastuzumab Emtansine

Topics

• Ado-Trastuzumab Emtansine
• Anthracyclines (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Brain (drug effects, pathology)
• Brain Neoplasms (drug therapy, pathology, secondary)
• Breast (drug effects, pathology)
• Breast Neoplasms (drug therapy, pathology)
• Capecitabine (therapeutic use)
• Chemotherapy, Adjuvant (methods)
• Female
• Humans
• Lapatinib
• Maytansine (analogs & derivatives, therapeutic use)
• Neoplasm Metastasis (drug therapy, pathology)
• Neoplasm Recurrence, Local (drug therapy, pathology)
• Quinazolines (therapeutic use)
• Receptor, ErbB-2 (analysis)
• Taxoids (therapeutic use)
• Trastuzumab (therapeutic use)