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Adjuvant Therapy for HER-2-Positive Early Breast Cancer

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Breast Disease

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Abstract

The discovery of human epidermal growth factor receptor 2 (HER-2/neu) and its role in the biology of breast cancer is one of the most important success stories in the history of breast cancer. The development of HER-2-targeted therapies has changed the natural history of HER-2-positive breast cancer dramatically in the past two decades. Success in the metastatic setting has been subsequently translated into improved clinical outcomes for women with HER-2-positive early-stage breast cancer. Multiple phase III clinical trials including Herceptin Adjuvant (HERA), Finland Herceptin (FinHer), Breast Cancer International Research Group (BCIRG) 006, and the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-31, have demonstrated that trastuzumab in combination with or subsequent to chemotherapy was associated with significant improvements in disease-free and overall survival in patients with HER-2-positive early breast cancer. Thus, the monoclonal antibody trastuzumab has been approved as the first and only molecularly targeted agent for the adjuvant treatment of HER-2-positive breast cancer. Despite tremendous progress in the treatment of HER-2-positive breast cancer, many questions regarding the optimal tailoring of anti-HER-2 therapy remain. Current adjuvant anti-HER-2 therapies need to be refined for different patient subsets with HER-2-positive tumors to provide personalized, effective, and minimally toxic treatment. Additional molecular biomarkers beyond HER-2 are necessary for the identification of low-risk patients who could benefit from less intensive or even no chemotherapy in combination with trastuzumab as well as for the identification of patients with resistance to anti-HER-2 therapy.

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Authors and Affiliations

  1. Medical Oncology Department, Medical Faculty, Acibadem University, Istanbul, Turkey

    Gul Basaran

  2. Department of Medical Oncology, Kocaeli University Hospital, Kocaeli, Turkey

    Devrim Cabuk

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  1. Gul Basaran
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  1. Oncology Institute, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Adnan Aydiner

  2. Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Abdullah Igci

  3. Division of Surgical Oncology, Department of Surgery, University of Pittsburgh School of Medicine, Magee-Women’s Hospital of UPMC, Pittsburgh, PA, USA

    Atilla Soran

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Basaran, G., Cabuk, D. (2019). Adjuvant Therapy for HER-2-Positive Early Breast Cancer. In: Aydiner, A., Igci, A., Soran, A. (eds) Breast Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-16792-9_9

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