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Innovative Therapeutic Approaches for Patients with HER2-Positive Breast Cancer

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Breast Cancer Research and Treatment

Part of the book series: Cancer Treatment and Research ((CTAR,volume 188))

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Abstract

Overexpression of human epidermal growth factor receptor 2 (HER2), a transmembrane tyrosine kinase receptor, has been described in about 15–20% of breast cancer (BC) and is associated with poor outcomes. Trastuzumab is the first anti-HER2 monoclonal antibody (mAB) that blocks receptor activity but it also activates immune response against cancer cells, thus, revolutionizing the prognosis of patients with HER2-positive BC. Over the years, new therapies have been developed, including other mAbs and tyrosine kinase inhibitors (TKIs) that required multimodal approaches with chemotherapy to optimize their anticancer activity. This chapter gives a comprehensive overview of the last advancements including new approaches and future combinations, which seem to be very promising in overcoming resistance to the traditional anti-HER2 treatments. A modern therapeutic algorithm should include treatment options based on tumour patterns and a patient-centred approach. A proper patient’s selection is crucial to derive maximal benefits from a treatment strategy and emerging biomarkers should be integrated along with the HER2 status, which is currently the only validated biomarker in the context of HER2-positive disease. These biomarkers might include molecular features with reported prognostic/predictive significance, such as phosphatidylinositol 3’ -kinase (PI3K) or mitogen-activated protein kinase (MAPK) pathways, programmed cell death protein ligand 1 (PD-L1), and tumour-infiltrating lymphocytes (TILs), which all affect prognosis and response to treatments.

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Authors and Affiliations

  1. Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Via G. Ripamonti 435, 20141, Milan, Italy

    Beatrice Taurelli Salimbeni, Luca Boscolo Bielo & Giuseppe Curigliano

  2. Department of Clinical and Molecular Medicine, Oncology Unit, “La Sapienza” University of Rome, Azienda Ospedaliera Sant’Andrea, Rome, Italy

    Beatrice Taurelli Salimbeni

  3. Breast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA

    Emanuela Ferraro

  4. Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy

    Luca Boscolo Bielo & Giuseppe Curigliano

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  1. Beatrice Taurelli Salimbeni
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  2. Emanuela Ferraro
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  3. Luca Boscolo Bielo
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  4. Giuseppe Curigliano
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Correspondence to Giuseppe Curigliano .

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  1. Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco

    Ouissam Al Jarroudi

  2. Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco

    Khalid El Bairi

  3. Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, Italy

    Giuseppe Curigliano

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GC received honoraria for speaker, consultancy, or advisory rule from AstraZeneca, Roche, Pfizer, Novartis, Seattle Genetics, Lilly, Ellipses Pharma, Foundation Medicine, Daiichi Sankyo, and Samsung. The other authors have no disclosures to report.

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Taurelli Salimbeni, B., Ferraro, E., Boscolo Bielo, L., Curigliano, G. (2023). Innovative Therapeutic Approaches for Patients with HER2-Positive Breast Cancer. In: Al Jarroudi, O., El Bairi, K., Curigliano, G. (eds) Breast Cancer Research and Treatment. Cancer Treatment and Research, vol 188. Springer, Cham. https://doi.org/10.1007/978-3-031-33602-7_10

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