Review of the Status of Neoadjuvant Therapy in HER2-positive Breast Cancer

Overview

Journal Front Oncol

Specialty Oncology

Date 2023 Feb 16

PMID 36793602

Authors

Gavin P Dowling

Stephen Keelan

Sinead Toomey

Gordon R Daly

Bryan T Hennessy

Arnold D K Hill

Affiliations

Soon will be listed here.

Abstract

Purpose: The development of human epidermal growth factor receptor 2 (HER2)-directed therapies has revolutionized the treatment of HER2-positive breast cancer. The aim of this article is to review the continually evolving treatment strategies in the neoadjuvant setting of HER2-positive breast cancer, as well as the current challenges and future perspectives.

Methods: Searches were undertaken on PubMed and Clinicaltrials.gov for relevant publications and trials.

Findings: The current standard of care in high-risk HER2-positive breast cancer is to combine chemotherapy with dual anti-HER2 therapy, for a synergistic anti-tumor effect. We discuss the pivotal trials which led to the adoption of this approach, as well as the benefit of these neoadjuvant strategies for guiding appropriate adjuvant therapy. De-escalation strategies are currently being investigated to avoid over treatment, and aim to safely reduce chemotherapy, while optimizing HER2-targeted therapies. The development and validation of a reliable biomarker is essential to enable these de-escalation strategies and personalization of treatment. In addition, promising novel therapies are currently being explored to further improve outcomes in HER2-positive breast cancer.

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