HER2-positive breast cancer

• Published in: The Lancet (British edition) 2017-06, Vol.389 (10087), p.2415-2429
• Main Authors: Loibl, Sibylle, Prof, Gianni, Luca, MD
• Format: Article
• Language: English
• Subjects: Antineoplastic Agents, Immunological - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological products; Biology; Breast cancer; Breast Neoplasms - chemistry; Breast Neoplasms - drug therapy; Cancer; Cancer therapies; Chemotherapy; Endocrine therapy; Epidermal growth factor; ErbB-2 protein; Fatalities; Female; Genes; Humans; Immunotherapy; Internal Medicine; Kinases; Maytansine - analogs & derivatives; Maytansine - therapeutic use; Metastases; Metastasis; Molecular Targeted Therapy - methods; Monoclonal antibodies; Mutation; Neoadjuvant Therapy - methods; Neoplasm Metastasis; Patients; Prognosis; Radiation therapy; Receptor, Epidermal Growth Factor - physiology; Receptor, ErbB-2 - analysis; Receptor, ErbB-2 - antagonists & inhibitors; Series (mathematics); Survival; Targeted cancer therapy; Therapy; Trastuzumab; Trastuzumab - therapeutic use; Womens health
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(16)32417-5

Summary Anti-HER2 treatment for HER2-positive breast cancer has changed the natural biology of this disease. This Series article reviews the main achievements so far in the treatment of both metastatic and early HER2-positive breast cancer. The success of neoadjuvant therapy in HER2-positive early breast cancer is especially acknowledged, as pertuzumab has been approved on the basis of a higher proportion of patients achieving a pathological complete response with pertuzumab and trastuzumab than with trastuzumab alone in a neoadjuvant study. Event-free survival after the confirmatory adjuvant trial completed recruitment was numerically better with pertuzumab plus trastuzumab than with trastuzumab alone. With survival rates of almost 5 years in women with metastatic HER2-positive breast cancer and 75% of patients achieving a pathological complete response, new treatments in the past decade have clearly improved the prognosis of HER2-positive breast cancer. Despite these achievements, however, the persisting high toll of deaths resulting from HER2-positive breast cancer calls for continued, intensive clinical research of newer therapies and combinations.