What is the prognosis of breast cancer following HER2-targeted therapies?

Updated: Feb 04, 2021
  • Author: Pavani Chalasani, MD, MPH; Chief Editor: John V Kiluk, MD, FACS  more...
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In the past, HER2 overexpression was associated with a more aggressive tumor phenotype and a worse prognosis (higher recurrence rate and increased mortality), independent of other clinical features (eg, age, stage, and tumor grade), especially in patients who did not receive adjuvant chemotherapy. Prognosis has improved with the routine use of HER2-targeted therapies, which consist of the following:

  • Trastuzumab – Monoclonal antibody
  • Pertuzumab – Monoclonal antibody
  • Lapatinib – A small-molecule oral tyrosine kinase inhibitor
  • Neratinib – A small-molecule oral tyrosine kinase inhibitor
  • Ado-trastuzumab emtansine – An antibody-drug conjugate directed specifically to the HER2 receptor

HER2 status has also been shown to predict response to certain chemotherapeutic agents (eg, doxorubicin). Retrospectively analyzed results from clinical trials have shown that HER2-positive patients benefit from anthracycline-based regimens, perhaps because of the frequent coamplification of topoisomerase II with HER2. Preliminary data also suggest that HER2 positivity may predict response to and benefit from paclitaxel in the adjuvant setting. [76] (See Breast Cancer and HER2.)

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