title: Treatment of HER2-positive breast cancer: current status and future perspectives.
abstract: The advent of HER2-directed therapies has significantly improved the outlook for patients with HER2-positive early stage breast cancer. However, a significant proportion of these patients still relapse and die of breast cancer. Trials to define, refine and optimize the use of the two approved HER2-targeted agents (trastuzumab and lapatinib) in patients with HER2-positive early stage breast cancer are ongoing. In addition, promising new approaches are being developed including monoclonal antibodies and small-molecule tyrosine kinase inhibitors targeting HER2 or other HER family members, antibodies linked to cytotoxic moieties or modified to improve their immunological function, immunostimulatory peptides, and targeting the PI3K and IGF-1R pathways. Improved understanding of the HER2 signaling pathway, its relationship with other signaling pathways and mechanisms of resistance has also led to the development of rational combination therapies and to a greater insight into treatment response in patients with HER2-positive breast cancer. Based on promising results with new agents in HER2-positive advanced-stage disease, a series of large trials in the adjuvant and neoadjuvant settings are planned or ongoing. This Review focuses on current treatment for patients with HER2-positive breast cancer and aims to update practicing clinicians on likely future developments in the treatment for this disease according to ongoing clinical trials and translational research.
authors: Breast Cancer Research Program, Vanderbilt Ingram Comprehensive Cancer Center, Vanderbilt University School of Medicine, 1310 24th Avenue South, Nashville, TN 37212-2637, USA.
authors: Carlos L
authors: CL
authors: Arteaga
authors: Mark X
authors: MX
authors: Sliwkowski
authors: C Kent
authors: CK
authors: Osborne
authors: Edith A
authors: EA
authors: Perez
authors: Fabio
authors: F
authors: Puglisi
authors: Luca
authors: L
authors: Gianni
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics; D019496:Cancer Vaccines; D018450:Disease Progression; D005260:Female; D005784:Gene Amplification; D018734:Genes, erbB-2 / Q000235:genetics*; D006360:Heat-Shock Proteins; D006801:Humans; D000077341:Lapatinib; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011799:Quinazolines / Q000627:therapeutic use*; D017526:Receptor, IGF Type 1; D000068878:Trastuzumab
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D019496:Cancer Vaccines; D006360:Heat-Shock Proteins; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077341:Lapatinib; D011505:Protein-Tyrosine Kinases; D017526:Receptor, IGF Type 1; D000068878:Trastuzumab