This review discusses the treatment of primary, nonmetastatic HER2-positive breast cancer in the adjuvant and neoadjuvant settings—settings in which tremendous progress has been made.
Breast Cancer Targets
Therapies targeting HER2 have revolutionized the treatment of breast cancer. Trastuzumab is the foundation of treatment for women with HER2-positive breast cancer. The challenge ahead is to develop predictors that can identify patients for whom trastuzumab alone will be sufficient.
It will be critically important to await the longer-term DFS and OS results from the neoadjuvant studies, as well as the adjuvant studies evaluating dual HER2 blockade, prior to these approaches truly becoming the standard of care.
Two early trials studying CDK inhibitors in metastatic breast cancer have shown impressive activity in HR-positive disease, according to data presented at the AACR annual meeting.
Pertuzumab and Its Accelerated Approval: Evolving Treatment Paradigms and New Challenges in the Management of HER2-Positive Breast Cancer
This article discusses the development of pertuzumab to date, with a particular focus on the accelerated approval decision. We highlight the need to identify reliable biomarkers of sensitivity and resistance to HER2-targeted therapy, which would make possible the individualization of treatment for patients with HER2-positive breast cancer.
Contrary to some expectations, getting accelerated approval for neoadjuvant therapy does not look easy, and the pertuzumab story may be the exception that proves the rule.
At this point, there is expectation that pertuzumab given in the neoadjuvant setting will improve long-term efficacy. We welcome the opportunity to include pertuzumab in the neoadjuvant regimen of patients with HER2-positive breast cancer.
Researchers have reported the results of the first large-scale, whole-genome study of advanced breast cancer. The analysis of the sequences has resulted in identification of a subset of patients who have a higher chance of benefiting from specific personalized therapy.
Scientists have discovered that the injection of an engineered virus into triple-negative breast cancer cells may allow the cancers to be treated with therapeutic radioiodine, a treatment traditionally used to treat thyroid cancers.
Final overall survival results of a trial comparing fulvestrant doses found that postmenopausal women with metastatic, ER–positive breast cancer had a 19% lower risk of death when taking a 500-mg dose compared with a 250-mg dose.