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Trastuzumab in the Treatment of Breast Cancer

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Abstract

Breast cancer (BC) is the most common cancer in women worldwide, and has an undeniable negative impact on public health. The advent of molecular biology and immunotherapy has made targeted therapeutic interventions possible, providing treatments tailored to the individual characteristics of the patient and the disease. The over-expression of human epidermal growth factor receptor (HER) 2 is implicated in the pathophysiology of BC and represents a clinically relevant biomarker for its treatment. Trastuzumab, a recombinant antibody targeting HER2, was the first biological drug approved for the treatment of HER2-positive BC. Although there are currently other anti-HER2 agents available (e.g. pertuzumab and lapatinib), trastuzumab remains the gold standard for treatment of this disease subtype. Nonetheless, concerns have been raised regarding potential cardiotoxicity and treatment resistance. Moreover, several other therapeutic issues remain unclear and have been addressed in an inconsistent way. The current literature lacks a comprehensive review of trastuzumab providing useful information for clinical practice, including pharmacokinetic and pharmacodynamic aspects, its clinical use, existing controversies and future advances. This detailed review of trastuzumab in the pharmacotherapy of BC attempts to fill this gap.

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Authors and Affiliations

  1. CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Av. Infante D. Henrique, Covilhã, Portugal

    Sofia Maximiano, Paulo Magalhães & Manuel Morgado

  2. Cova da Beira Hospital Centre, E.P.E., Quinta do Alvito, 6200-251, Covilhã, Portugal

    Manuel Morgado

  3. Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, Coimbra, Portugal

    Paulo Magalhães

  4. CNC, Centre for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal

    Paulo Magalhães

  5. CICAB, Clinical Research Centre, Extremadura University Hospital and Medical School, Badajoz, Spain

    Paulo Magalhães

  6. Lisbon Nursing School (ESEL), Lisbon, Portugal

    Mara Pereira Guerreiro

  7. CiiEM, Institute of Health Sciences Egas Moniz (ISCSEM), Monte de Caparica, Portugal

    Mara Pereira Guerreiro

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Sofia Maximiano—acquisition, analysis and interpretation of data, drafting of the manuscript and technical support; Paulo Magalhães—analysis and interpretation of data, drafting of the manuscript and critical revision of the manuscript for important intellectual content; Mara Pereira Guerreiro—analysis and interpretation of data and critical revision of the manuscript for important intellectual content; Manuel Morgado—concept and study design and critical revision of the manuscript for important intellectual content.

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Sofia Maximiano, Paulo Magalhães, Mara Pereira Guerreiro and Manuel Morgado state that they have no conflicts of interest regarding the publication of this article. Research funding played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Maximiano, S., Magalhães, P., Guerreiro, M.P. et al. Trastuzumab in the Treatment of Breast Cancer. BioDrugs 30, 75–86 (2016). https://doi.org/10.1007/s40259-016-0162-9

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