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Addressing Residual Disease in HER2-Positive and Triple-Negative Breast Cancer: What Is Next?

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Abstract

Purpose of review

To summarize the treatment strategies for patients with human epidermal growth factor receptor 2 (HER2)-positive disease and triple-negative breast cancer (TNBC) who have residual disease after preoperative systemic therapy.

Recent findings

There has been a shift towards neoadjuvant systemic therapy for selected patients with HER2-positive and TNBC. Assessing the tumor’s response to therapy provides prognostic information and allows individualization of the postoperative treatment for these patients based on the tumor response to neoadjuvant therapy. Patients with TNBC with residual disease after neoadjuvant therapy can be treated with pembrolizumab, capecitabine, or olaparib. Those with HER2-positive disease are treated with adjuvant trastuzumab emtansine.

Summary

The treatment of early breast cancer has evolved significantly, and patient outcomes continue to improve. As better treatments are developed, we will need biomarkers to determine which patients may benefit from certain therapies to continue to improve outcomes by right-sizing treatments and limiting toxicities.

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Acknowledgements

FL acknowledges the Benderson Family Fund for support. We thank Kate Bifolck for editing and submission assistance. She is a full-time employee of Dana-Farber Cancer Institute.

Author information

Authors and Affiliations

  1. Division of Hematology and Oncology, Tufts Medical Center, Boston, MA, USA

    Ilana Schlam & Joshua Dower

  2. Tufts University, Boston, MA, USA

    Ilana Schlam

  3. Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA

    Filipa Lynce

  4. Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA

    Filipa Lynce

  5. Harvard Medical School, Boston, MA, USA

    Filipa Lynce

Authors
  1. Ilana Schlam
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Contributions

I.S. and F.L. conceptualized the review. I.S. wrote the main manuscript text, and I.S. and J.D. prepared the figures and tables. All authors reviewed the manuscript.

Corresponding author

Correspondence to Filipa Lynce.

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Competing Interests

Ilana Schlam: Nothing to disclose.

Joshua Dower: Nothing to disclose.

Filipa Lynce: Consulting or advisory role for: AstraZeneca, Pfizer, Eli Lilly, Daiichi Sankyo; Research funding (to institution): Eisai, Incyte, AstraZeneca, Merck, Zentalis, Genentech, CytomX.

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Schlam, I., Dower, J. & Lynce, F. Addressing Residual Disease in HER2-Positive and Triple-Negative Breast Cancer: What Is Next?. Curr Oncol Rep 26, 336–345 (2024). https://doi.org/10.1007/s11912-024-01501-0

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