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Current Oncology Reports
Published in: Current Oncology Reports 12/2019

01-12-2019 | Breast Cancer | Breast Cancer (B Overmoyer, Section Editor)

When to Add Additional Anti-HER2 Therapy to Adjuvant Trastuzumab

Authors: Alexandra S. Zimmer, Neelima Denduluri

Published in: Current Oncology Reports | Issue 12/2019

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Abstract

Purpose of Review

One year of trastuzumab dramatically improves outcomes in early HER2 positive breast cancer, irrespective of anatomic stage, receptor status and chemotherapy backbone. However, up to 25% of breast cancers treated with trastuzumab and chemotherapy recur. Here, we review the current role for additional HER2 blockade to adjuvant trastuzumab.

Recent Findings

Adjuvant pertuzumab and neratinib modestly improve disease-free survival in early breast cancer, particularly for those at highest risk of recurrence. Lack of complete pathologic response to preoperative chemotherapy and HER2 targeted therapies is associated with worse outcomes. In those with lack of pCR, adjuvant trastuzumab emtansine improves outcome in early breast cancer, irrespective of chemotherapy and HER2 targeted therapy backbone.

Summary

Preoperative chemotherapy and HER2 targeted therapy should be discussed in early breast cancer, especially in tumors over 2 cm. Future trials must focus on de-escalation of chemotherapy and biomarkers for further tailored therapy in early HER2 positive breast cancer.
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Metadata
Title
When to Add Additional Anti-HER2 Therapy to Adjuvant Trastuzumab
Authors
Alexandra S. Zimmer
Neelima Denduluri
Publication date
01-12-2019
Publisher
Springer US
Published in
Current Oncology Reports / Issue 12/2019
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-019-0848-5

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