Abstract
Expression of human epidermal growth factor receptor 2 (HER2) in breast cancer defines
a subset of patients (∼15%-20%) who are candidates for anti-HER2 therapies, most notably,
trastuzumab, pertuzumab, antibody drug conjugates (eg, T-DM1), and tyrosine kinase
inhibitor (TKI) drugs (eg, lapatinib and neratinib), all of which have dramatically
changed the prognosis for this aggressive subtype of breast cancer. A roundtable meeting
of the Breast Cancer Therapy Expert Group (BCTEG) was convened in March 2018 in an
effort to discuss and clarify, from the perspective of the practicing community oncologist,
recent developments in the diagnosis and treatment of HER2-positive (HER2+) breast cancer. Members of the group selected 4 key topics for discussion prior to
the meeting, including diagnosis of HER2+ disease, and its treatment in the neoadjuvant, adjuvant, and metastatic settings.
Approved testing methods, such as immunohistochemistry and fluorescence in situ hybridization,
are used to demonstrate overexpression and/or amplification of HER2 in breast tumors,
and established clinical guidelines are used to appropriately define treatment plans
for patients with HER2+ disease. The panel acknowledges a range of treatment options now available for treatment
of HER2+ breast cancer in the neoadjuvant, adjuvant, and advanced/metastatic settings, although
it is noted that many controversies remain, including the optimal sequence of therapies,
the most appropriate treatment(s) for subsets of patients with HER2+ disease (eg, hormone receptor-negative or -positive/HER2+), and uncertainties surrounding the diagnosis and definition of HER2+ disease. The current report summarizes the discussion of the BCTEG panel on this
topic.
Keywords
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Article info
Publication history
Published online: August 21, 2019
Accepted:
August 12,
2019
Received in revised form:
July 17,
2019
Received:
March 7,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
