title: Current challenges in HER2-positive breast cancer.
abstract: The introduction of trastuzumab into routine clinical practice has had a dramatic effect on the outlook for patients with HER2-positive breast cancer. Nevertheless, answers to some long unresolved questions about the optimal use of trastuzumab (such as its role in small tumors or low-risk disease, cardiac safety in the elderly, and treatment duration) have emerged only relatively recently. Moreover, with the availability of new highly effective HER2-directed therapies, including pertuzumab and trastuzumab-emtansine (T-DM1), the treatment algorithm for HER2-positive breast cancer continues to evolve. This review provides a summary of the latest evidence providing insight into the management of early and advanced HER2-positive breast cancer and delineates future perspectives of study and treatment for these patients.
authors.affiliation: Department of Medical and Biological Science, University of Udine, Udine, Italy; Department of Oncology, University Hospital of Udine, Udine, Italy. Electronic address: fabio.puglisi@uniud.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Puglisi
authors.affiliation: Department of Medical and Biological Science, University of Udine, Udine, Italy; Department of Oncology, University Hospital of Udine, Udine, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Fontanella
authors.affiliation: Department of Oncology, Spedali Civili Hospital, Brescia, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Amoroso
authors.affiliation: Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.
authors.forename: Giulia Valeria
authors.initials: GV
authors.lastname: Bianchi
authors.affiliation: Department of Oncology, Arcispedale Santa Maria Nuova Hospital, Reggio Emilia, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Bisagni
authors.affiliation: Division of Medical Oncology II Veneto Istitute of Oncology, IOV - IRCCS, Padova, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Falci
authors.affiliation: Department of Oncology, Hospital and University of Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fontana
authors.affiliation: Dipartimento Universitario Clinico di Scienze Mediche, Chirurgiche e della Salute Università degli Studi di Trieste, Tieste, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
authors.affiliation: Department of Oncology, Infermi Hospital, Rimini, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Gianni
authors.affiliation: Department of Oncology, G. D'Annunzio University-SS Annunziata Hospital, Chieti, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Grassadonia
authors.affiliation: Department of Oncology, Belcolle Hospital, Viterbo, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Moscetti
authors.affiliation: Department of Oncology, Tor Vergata Hospital, Roma, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Portarena
authors.affiliation: Department of Oncology, SG Moscati Hospital, Avellino, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Rossi
authors.affiliation: Facoltà di Medicina e Psicologia "Sapienza" Università di Roma, Ospedale Sant'Andrea & IDI - I.R.C.C.S., Roma, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchetti
mesh_terms: D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000401:mortality; D002986:Clinical Trials as Topic; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis* / Q000037:antagonists & inhibitors*; D000068878:Trastuzumab / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Breast cancer; Dual targeting; HER2; Lapatinib; Neoadjuvant; Pertuzumab; Trastuzumab; Trastuzumab-emtansine