Review of treatment strategies for HER2 positive breast cancer and their implementation in a major Swiss hospital

2020 ◽  
Author(s):  
F Geissler ◽  
M Vetter ◽  
A Schoetzau ◽  
C Montavon ◽  
C Kurzeder ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Strategies ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

scholarly journals Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)–Positive Breast Cancer

2020 ◽  
Vol 3 (11) ◽  
pp. e2027074
Author(s):  
Natalia Kunst ◽  
Shi-Yi Wang ◽  
Annette Hood ◽  
Sarah S. Mougalian ◽  
Michael P. DiGiovanna ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Adjuvant Treatment ◽  
Treatment Strategies ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

scholarly journals Heterogeneity of luminal A and HER2-positive breast cancer based on DIA quantitative proteomics and bioinformatics analysis techniques

2020 ◽  
Author(s):  
Guogang Wu ◽  
Lei Zhang ◽  
Chunyan Liang ◽  
Yao Cheng ◽  
Chenguang Lv ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Strategies ◽  
Endocrine System ◽  
Luminal A ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Rho Family Gtpases ◽  
Rho Family ◽  
Cancer Tissues ◽  
Positive Breast Cancer

Abstract Background: Breast cancer has common tumor biological characteristics, but different characteristics also exist among different subtypes. Different treatment strategies have been adopted for different subtypes at present, but there are still many problems. Thus, an-depth study on the heterogeneity of different types of breast cancer will help to identify new diagnostic therapeutic targets and solve the existing problems of individualized treatment for breast cancer.Methods: In this study proteins of HER2-positive breast cancer, luminal A breast cancer, and para-cancer tissues were quantified based on data independent acquisition (DIA) proteomics technology, and the differentially expressed proteins (DEPs) were screened and analyzed by IPA software and the database among the luminal A (LA ) versus para-cancer tissues (PT) and HER2 versus LA groups.Results: There were 264 up- and 123 down-regulated proteins in the LA versus PT groups. PD-1 and PD-L1 cancer immunotherapy pathways were significantly inhibited, and XBP1 was predicted to be the strongest activator. MTOR was predicted to be the strongest inhibitor. The DEPs were significantly associated with “Cancer” and “Organismal Injury and Abnormalities.” There were 134 up- and 286 down-regulated proteins in the HER2 versus LA groups. Signaling by rho family GTPases was significantly inhibited. XBP1 was predicted to be the strongest activator. TGFB1 was predicted to be the strongest inhibitor. The DEPs were significantly associated with “Cancer,” “Endocrine System Disorders,” and “Organismal Injury and Abnormalities.”Conclusion: Luminal A breast cancer may be insensitive to PD-1 and PD-L1 inhibitors. Signaling by rho family GTPases and RhoGDI signaling play a unique role in the proliferation and metastasis of luminal A and HER2-positive breast cancer, respectively. XBP1 is a promising new target for the treatment of breast cancer, and TGFB1 may play different biological roles in HER2-positive and luminal A breast cancer.

scholarly journals Targeted Therapies in HER2-Positive Breast Cancer - a Systematic Review

Breast Care ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Amelie Schramm ◽  
Nikolaus De Gregorio ◽  
Peter Widschwendter ◽  
Visnja Fink ◽  
Jens Huober
Keyword(s):  
Breast Cancer ◽  
Targeted Therapies ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Her2 Overexpression ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Increased Risk ◽  
Positive Breast Cancer

About 20% of all breast cancer patients have a human epidermal growth factor receptor 2 (HER2)-positive breast tumor. This entity underwent an impressive change in prognosis, with notable improvement of progression-free survival and overall survival. Due to more aggressive tumors and no specific therapy, HER2 overexpression was historically seen as a negative prognostic marker, with worse prognosis and increased risk of recurrent disease. Trastuzumab, the first anti-HER2 antibody, revolutionized the systemic therapy options in HER2-positive breast cancer and initiated several targeted therapies and more personalized treatment strategies. Over the years, multiple HER2-targeting drugs stepped into clinical practice, for the curative as well as the metastatic situation. This review summarizes the targeted treatment options in HER2-positive breast cancer and their current impact in the clinical routine. Results of the most outstanding trials in HER2-targeted therapies and important ongoing trials are subsequently described for an up-to-date overview.

scholarly journals Best Foot Forward: Neoadjuvant Systemic Therapy as Standard of Care in Triple-Negative and HER2-Positive Breast Cancer

2020 ◽  
pp. e1-e16
Author(s):  
Priyanka Sharma ◽  
Roisin M. Connolly ◽  
Evanthia T. Roussos Torres ◽  
Alastair Thompson
Keyword(s):  
Breast Cancer ◽  
Systemic Therapy ◽  
Residual Disease ◽  
Early Stage ◽  
Treatment Strategies ◽  
Long Term Outcomes ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

Neoadjuvant systemic treatment of early-stage breast cancer has been used to improve resectability and reduce the extent of breast and axillary surgery. More recently, several other merits of neoadjuvant systemic treatment have emerged, including the ability to tailor clinically available adjuvant systemic therapy options based on pathologic response and to serve as a platform for early assessment of novel agents and response biomarkers and as an avenue for treatment optimization investigations (local and systemic therapy escalation and de-escalation trials guided by pathologic response). Attainment of a pathologic complete response (pCR) is associated with excellent long-term outcomes; conversely, the presence of residual disease is associated with a high risk of recurrence for patients with HER2-positive breast cancer and triple-negative breast cancer (TNBC). Treatment strategies in early-stage HER2-positive breast cancer include regimens incorporating trastuzumab, pertuzumab, ado-trastuzumab emtansine, and neratinib, resulting in high pCR rates and overall excellent long-term outcomes. Currently available cytotoxic regimens yield pCR for 35% to 55% of patients with TNBC, and immune checkpoint inhibition is showing early promise for this subtype. New drug and predictive biomarker evaluations in the neoadjuvant setting aim to develop optimal treatment strategies for the individual patient, with the ultimate goal of maximizing efficacy and minimizing toxicity. Research efforts involving novel agents are being undertaken to address the high risk of recurrence for patients with residual disease. Omission of breast surgery following neoadjuvant chemotherapy requires further development of imaging and biopsy techniques to accurately assess the extent of residual disease before clinical application.

scholarly journals Brain Metastases in HER2-Positive Breast Cancer: Current and Novel Treatment Strategies

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2927
Author(s):  
Alejandro Garcia-Alvarez ◽  
Andri Papakonstantinou ◽  
Mafalda Oliveira
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Treatment Strategies ◽  
Metastatic Breast ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Novel Treatment ◽  
Increased Risk ◽  
Novel Treatment Strategies ◽  
Positive Breast Cancer

Development of brain metastases can occur in up to 30–50% of patients with breast cancer, representing a significant impact on an individual patient in terms of survival and quality of life. Patients with HER2-positive breast cancer have an increased risk of developing brain metastases; however, screening for brain metastases is not currently recommended due to the lack of robust evidence to support survival benefit. In recent years, several novel anti-HER2 agents have led to significant improvements in the outcomes of HER2-positive metastatic breast cancer. Despite these advances, brain and leptomeningeal metastases from HER2-positive breast cancer remain a significant cause of morbidity and mortality, and their optimal management remains an unmet need. This review presents an update on the current and novel treatment strategies for patients with brain metastases from HER2-positive breast cancer and discusses the open questions in the field.

scholarly journals Targeting mTOR and Glycolysis in HER2-Positive Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2922
Author(s):  
Ryan W. Holloway ◽  
Paola A. Marignani
Keyword(s):  
Breast Cancer ◽  
Treatment Strategies ◽  
Mtor Pathway ◽  
Breast Cancers ◽  
Her2 Receptor ◽  
Her2 Positive ◽  
Risk Of Recurrence ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

Up to one third of all breast cancers are classified as the aggressive HER2-positive subtype, which is associated with a higher risk of recurrence compared to HER2-negative breast cancers. The HER2 hyperactivity associated with this subtype drives tumor growth by up-regulation of mechanistic target of rapamycin (mTOR) pathway activity and a metabolic shift to glycolysis. Although inhibitors targeting the HER2 receptor have been successful in treating HER2-positive breast cancer, anti-HER2 therapy is associated with a high risk of recurrence and drug resistance due to stimulation of the PI3K-Akt-mTOR signaling pathway and glycolysis. Combination therapies against HER2 with inhibition of mTOR improve clinical outcomes compared to HER2 inhibition alone. Here, we review the role of the HER2 receptor, mTOR pathway, and glycolysis in HER2-positive breast cancer, along with signaling mechanisms and the efficacy of treatment strategies of HER2-positive breast cancer.

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