Therapeutic Strategies for the Management of Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Positive (HR+/HER2+) Breast Cancer: A Review of the Current Literature.
Eirini ThanopoulouLeila KhaderMorena CairaAndrew M WardleyJohannes EttlFederica MigliettaPatrick NevenValentina GuarneriPublished in: Cancers (2020)
Enormous advances have been made in the understanding and treatment of human epidermal growth factor receptor 2-positive breast cancer (HER2+ BC) in the last 30 years that have resulted in survival gains for affected patients. A growing body of evidence suggests that hormone receptor-positive (HR+)/HER2+ BC and HR-negative (HR-)/HER2+ BC are biologically different, with complex molecular bidirectional crosstalk between the estrogen receptor and HER2 pathway potentially affecting sensitivity to both HER2-targeted and endocrine therapy in patients with HR+/HER2+ BC. Subgroup analyses from trials enrolling patients with HER2+ BC and the results of clinical trials specifically designed to evaluate therapy in patients with HR+/HER2+ BC are helping to guide treatment decisions. In this context, encouraging results with strategies aimed at delaying or reversing drug resistance, including extended adjuvant therapy and the addition of drugs targeting alternative pathways, such as cyclin-dependent kinase (CDK) 4 and 6 inhibitors, have recently emerged. We have reached the point where tailoring the treatment according to risk and biology has become the paradigm in early BC. However, further clinical trials are needed that integrate translational research principles and identify and consider specific patient subgroups and biomarkers.
Keyphrases
- epidermal growth factor receptor
- clinical trial
- tyrosine kinase
- advanced non small cell lung cancer
- endothelial cells
- positive breast cancer
- end stage renal disease
- cell cycle
- systematic review
- ejection fraction
- stem cells
- newly diagnosed
- peritoneal dialysis
- cell death
- patient reported outcomes
- induced pluripotent stem cells
- combination therapy
- chronic kidney disease
- drug delivery
- case report
- open label
- cell cycle arrest