A clinical perspective on escalating or de-escalating adjuvant therapy in HER2+ breast cancer. Issue 1 (2nd January 2019)

• Record Type: Journal Article
• Authors: Esposito, Angela; Viale, Giulia; Criscitiello, Carmen; Curigliano, Giuseppe
• Is Part Of: Expert review of clinical pharmacology. Volume 12:Issue 1(2019)
• Page Start: 9
• Page End: 16
• Publication Date: 2019-01-02
• Subjects: Adjuvant trastuzumab duration -- breast cancer -- HER2-positive breast cancer -- HER2-targeted therapy; Clinical pharmacology -- Periodicals; 615.105
• DOI: 10.1080/17512433.2019.1552134
• Languages: English
• ISSNs: 1751-2433

Abstract

ABSTRACT: Introduction : Patients with early HER2-positive breast cancer (BC) benefit from HER2-targeted systemic therapy. The endorsed standard adjuvant treatment for patients with early HER2-positive breast cancer is chemotherapy plus trastuzumab administered for 1 year. Areas covered : Several trials have investigated modifications of the standard treatment in terms of de-escalation by either shortening the duration or giving less resource-demanding regimens and in terms of escalation by either adding a second anti-HER2 agent or extending the duration of HER2-targeted treatment for more than 12 months. In this perspective, we would offer a comprehensive view of these trials and discuss their findings. Expert commentary : At the current state of knowledge, there are still open questions regarding the management of HER2+ BC patients, such as the most adequate duration of trastuzumab therapy, the optimal chemotherapy regimen that should be combined with trastuzumab, and the addition of a second anti-HER2 agent. Growing evidences suggest that some HER2+ BC patients may not need chemotherapy. If these patients could be recognized upfront, optimal response could potentially be reached with HER2-targeted therapy alone.