title: Neratinib in HER-2-positive breast cancer: results to date and clinical usefulness.
abstract: The management of HER-2-positive breast cancer has improved significantly with the use of targeted agents to the HER-2 signaling pathway. Despite the improved survival achieved with the use of trastuzumab and chemotherapy in both the adjuvant and metastatic setting, patients may still recur or progress; whilst preclinical data demonstrate that these cancer cells remain addicted to the HER-2 oncogene. Neratinib, an oral small molecule tyrosine-kinase inhibitor has efficacy in the metastatic and adjuvant setting of patients who have previously received trastuzumab-based treatment. Diarrhea, being a class effect of tyrosine-kinase inhibitor, is the most common side effect seen following neratinib administration, but recent data suggests that a prophylactic loperamide regimen can reduce the incidence of grade 3 diarrhea. Phase I through to III clinical trials of neratinib will be reviewed, with discussion of the postulated mechanism underlying diarrheal events and its management.
authors: Medical School Curtin University and Breast Cancer Research Centre, Hollywood Private Hospital, 909 Nedlands 6909, WA, Australia.
authors: Arlene
authors: A
authors: Chan
keywords: HER-2-positive breast cancer; neratinib; tyrosine kinase inhibitor