The Role of Neoadjuvant HER2-Targeted Therapies in HER2 Overexpressing Breast Cancers

Abstract

While a number of potential benefits exist for women receiving neoadjuvant systemic therapy for primary operable or inoperable breast cancer, the main advantage, which has been demonstrated consistently, is improved tumour resectability. Given the improvement in outcomes with the adjuvant use of trastuzumab in patients with HER2?positive early stage breast cancer, questions have been raised about the use of trastuzumab in the neoadjuvant setting. This manuscript will review the currently available data and outline suggestions from a panel of Canadian oncologists about the use of trastuzumab and other HER2-targeted agents in the neoadjuvant setting.

The panel’s focus was with suggestions regarding:

·        The use of trastuzumab and other HER2-targeted agents as neoadjuvant therapy in primary operable, locally advanced or inflammatory breast cancer;

·        Possible choices of chemotherapeutic regimens with trastuzumab.

 

The suggestions described here will continue to evolve as data and future trials with trastuzumab and other HER2-targeted agents emerge.