Human epidermal growth factor receptor 2 (her2)-positive and hormone receptor-positive breast cancer: New insights into molecular interactions and clinical implications

Research output: Contribution to journalArticlepeer-review

Abstract

Recent data show a significant benefit from combining an anti-HER-2 agent with endocrine therapy in HER2-positive and hormone receptor (HR)-positive metastatic breast cancer. However, as the clinical outcomes achieved by these combinations do not favourably match those with chemotherapy, clinicians still perceive HER2-positive breast cancer as an homogeneous group and consider chemotherapy with anti-HER2 agents as the preferred treatment option, regardless of the HR status. Indeed, in HR-positive HER2-positive tumours, chemotherapy with anti-HER2 agents is the backbone of treatment, while endocrine therapy is commonly used in sequence when HR and HER2 are co-expressed rather than as a real alternative. Emerging biological and clinical data challenge this paradigm, suggesting that HER2-positive tumours are rather heterogeneous that HRs co-expression may account for part of this heterogeneity and, finally, that chemotherapy may represent an overtreatment in selected cases. The present review aims to summarise the biological features of HER2-positive breast cancer according to HR status, the role of the bi-directional cross-talk between HER2 and HR pathways on resistance development to anti-HER2 and endocrine therapy, and finally, the novel therapeutic strategies, including but not limited to chemotherapy, targeting these two pathways.

Original languageEnglish
Article numbermdt287
Pages (from-to)2715-2724
Number of pages10
JournalAnnals of Oncology
Volume24
Issue number11
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Breast cancer
  • Cancer metastasis
  • Drug therapy
  • Her2/neu
  • Hormone receptors
  • Resistance

ASJC Scopus subject areas

  • Oncology
  • Hematology

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