J Clin Outcomes Manage
HER2-positive breast cancer
Tolaney SM, Lin NU, Winer EP
Abstract Objective: To review the diagnosis and management of HER2-positive breast cancer. Methods: Qualitative review of the literature. Results: Amplification of HER2 occurs in 20% to 25% of breast cancers and is associated with high-grade tumors that are poorly differentiated and have higher rates of recurrence. Trastuzumab, a recombinant humanized monoclonal antibody against the extracellular domain of HER2, has dramatically changed the treatment of HER2-positive breast cancer. Clinical studies demonstrate that trastuzumab can significantly improve disease-free survival and overall survival in patients with HER2-positive disease in both the adjuvant and advanced settings. Trastuzumab is generally well-tolerated but can result in cardiac toxicity in about 2% to 4% of patients receiving an anthracycline-based regimen. Conclusion: Trastuzumab is now established as standard treatment for this subtype of breast cancer. Further work is needed to elucidate the mechanism of trastuzumab and trastuzumab resistance.
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