HER2-Directed Therapy in Advanced Breast Cancer: Benefits and Risks

Abstract

Around 20% of breast cancers are associated with amplification or overexpression of human epidermal growth factor receptor 2 (HER2). In this setting, anti-HER2-targeted agents are the cornerstone of cancer therapeutic strategies. This includes monoclonal antibodies, tyrosine kinase inhibitors (TKIs) and, recently, antibody–drug conjugates (ADCs). With the advent of these new alternatives, the decision-making process has become more complex, especially with regard to the treatment sequence possibilities. In spite of the fact that overall survival has significantly improved accordingly, resistance to treatment remains a challenge in HER2-positive breast cancer. The introduction of new agents has created awareness regarding new potential specific adverse events, and consequently, their increasing application pose major challenges in daily patient care. This review describes the therapeutic landscape for HER2-positive advanced breast cancer (ABC) and evaluates its benefits and risks in the clinical setting.

Keywords:

• breast cancer
• HER2
• monoclonal antibodies
• tyrosine kinase inhibitors
• antibody–drug conjugates

Acknowledgments

We would like to thank Angeles Baeck for preparing manuscript graphs and figures.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

No sponsor was involved in any of the stages from study design to submission of the manuscript for publication.