title: HER story: the next chapter in HER-2-directed therapy for advanced breast cancer.
abstract: Untreated human epidermal growth factor receptor-2 (HER-2)-positive advanced breast cancer (ABC) is an aggressive disease, associated with a poor prognosis and short overall survival. HER-2-directed therapy prolongs both time to disease progression and overall survival when combined with chemotherapy and has become the standard of care for those with HER-2-positive breast cancer in the early and advanced settings. Despite the remarkable therapeutic impact HER-2-directed therapy has had on disease outcomes, some patients with HER-2-positive disease will have primary resistant disease and others will respond initially but will eventually have progression, underscoring the need for other novel therapeutic options. This article reviews recent phase III trial data and discusses a practical approach to sequencing of HER-2-directed therapy in patients with HER-2-positive ABC. The significant cumulative survival gains seen in these trials are slowly reshaping the landscape of HER-2-positive ABC outcomes.
authors.affiliation: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada;
authors.forename: Sunil
authors.initials: S
authors.lastname: Verma
authors.forename: Anil A
authors.initials: AA
authors.lastname: Joy
authors.forename: Daniel
authors.initials: D
authors.lastname: Rayson
authors.forename: Deanna
authors.initials: D
authors.lastname: McLeod
authors.forename: Christine
authors.initials: C
authors.lastname: Brezden-Masley
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Boileau
authors.forename: Karen A
authors.initials: KA
authors.lastname: Gelmon
mesh_terms: D001943:Breast Neoplasms / Q000188:drug therapy* / Q000201:enzymology*; D017326:Clinical Trials, Phase III as Topic; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D058990:Molecular Targeted Therapy; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*; D016019:Survival Analysis
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Advanced breast cancer; HER-2-directed therapy; HER-2-positive; Lapatinib; Pertuzumab; T-DM1; Trastuzumab