Evolution of HER-Positive Breast Cancer Treatments

HER2-positive breast cancer was once considered a death sentence, with patients facing just two to three years of life expectancy before the advent of Trastuzumab (Herceptin). This anti-HER receptor therapy, introduced 24 years ago, marked a turning point, transforming the treatment landscape.

Expanding Arsenal: New Drugs Enter the Fight

Following Herceptin’s success, several new classes of drugs have emerged:

T-DM1 trastuzumab emtansine (KADCYLA): A drug conjugate used as a second-line or extended adjuvant therapy and Tyrosine Kinase Inhibitors (TKIs): Four oral medications – lapatinib, neratinib, pyrotinib, and tucatinib – offer targeted treatment options.

A Game-Changer in HER2-Positive Breast Cancer?

Trastuzumab deruxtecan (T-DXd), known as ENHERTU, is a recent drug conjugate generating some excitement. In clinical trials, it has surpassed T-DM1, becoming the most effective single agent for treating HER2-positive breast cancer. Currently positioned as a second-line therapy, ENHERTU’s potential might extend further.

Shaking Up First-Line Treatment: The Future of HER2 Therapy

Ongoing trials are challenging the standard first-line treatment regimen – pertuzumab, trastuzumab, and chemotherapy (CLEOPATRA trial) – with T-DXd showing promise as a potential replacement. Within a year or two, we could see a paradigm shift in how HER2-positive breast cancer is treated, offering patients greater hope for the future.

This article has been reviewed and edited by Dr JP Minart