title: HER2-overexpressing breast cancer:  time for the cure with less chemotherapy?
abstract: OBJECTIVE
  There have been recent new developments in the treatment of breast cancer that over-expresses HER2 (ERRB2/HER2 positive) and the mechanistic understanding of trastuzumab response. We review these findings and reflect on how they may influence the next generation of clinical trials in this breast cancer subtype.
  
  
  RESULTS
  Two recent trials in the neoadjuvant setting report that treatment with dual anti-HER2 agents was superior, in terms of rates of pathological complete response, to trastuzumab alone. Recent data also highlight that HER2 positive disease is biologically different according to estrogen receptor status and for long lasting clinical remissions, anti-HER2 therapy also seems to require an effective adaptive immune response.
  
  
  CONCLUSIONS
  We are currently in a very exciting era for therapeutic approaches in HER2 positive disease. Recent data suggest that intensive chemotherapy regimens may not be required for some women if we can determine the most potent combinations of signal inhibitors. We also propose that different clinical trials may need to be designed for HER2 positive breast cancer according to estrogen receptor status and consider incorporating immunotherapeutic approaches.
authors.affiliation: Breast Cancer Translational Research Laboratory, Institut Jules Bordet, L'Université Libre de Bruxelles, Brussels, Belgium. sherene.loi@bordet.be
authors.forename: Sherene
authors.initials: S
authors.lastname: Loi
authors.forename: Evandro
authors.initials: E
authors.lastname: de Azambuja
authors.forename: Lina
authors.initials: L
authors.lastname: Pugliano
authors.forename: Christos
authors.initials: C
authors.lastname: Sotiriou
authors.forename: Martine J
authors.initials: MJ
authors.lastname: Piccart
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000201:enzymology*; D005260:Female; D006801:Humans; D008325:Mammary Neoplasms, Experimental / Q000188:drug therapy / Q000201:enzymology; D058990:Molecular Targeted Therapy; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors* / Q000096:biosynthesis*
chemical_list: D047428:Protein Kinase Inhibitors; D018719:Erb-b2 Receptor Tyrosine Kinases