This section discusses targeted therapy drugs for HER2-positive early and locally advanced breast cancer.
Learn about targeted therapy drugs for HER2-positive metastatic breast cancer (also called advanced or stage IV breast cancer).
Some breast cancers have high amounts of a protein called HER2 on the surface of the cancer cells (called HER2-positive breast cancer). The HER2 protein is important for cancer cell growth.
HER2 targeted therapy drugs (anti-HER2 drugs) target HER2-positive breast cancers. They have no role in the treatment of HER2-negative cancers.
The HER2 status of a tumor is determined by testing tissue removed during a biopsy.
All newly diagnosed breast cancers are tested for HER2 status.
About 10-20 percent of newly diagnosed breast cancers are HER2-positive [102,221]. These breast cancers can be treated with HER2 targeted therapy drugs.
Learn more about HER2 status.
Trastuzumab is a specially made antibody that targets HER2-positive cancer cells.
When attached to the HER2 protein, trastuzumab can slow or stop the growth of these cancer cells.
Studies show for women with HER2-positive early breast cancer, chemotherapy plus trastuzumab cuts the risk of recurrence in half compared to chemotherapy alone [103-105].
Trastuzumab is given by vein (through an IV) every 3 weeks for 1 year.
Trastuzumab is also used to treat HER2-positive locally advanced and metastatic breast cancers.
Learn about neoadjuvant (before breast surgery) treatment with trastuzumab.
Learn more about treatment for HER2-positive metastatic breast cancers.
For a summary of research studies on trastuzumab and overall survival in early breast cancer, visit the Breast Cancer Research Studies section.
For a summary of research studies on trastuzumab and treatment for metastatic breast cancer, visit the Breast Cancer Research Studies section.
Trastuzumab use is linked to congestive heart failure, a serious heart condition.
In clinical trials, about 2-3 percent of those treated with chemotherapy plus trastuzumab had heart failure, compared to fewer than 1 percent of those treated with chemotherapy alone [103-104,106].
This risk of heart problems may be higher with chemotherapy regimens containing an anthracycline compared to regimens without an anthracycline .
The risk of heart problems may also be higher for women older than 65 and for those who already have heart problems.
For most people who develop a heart problem while taking trastuzumab, the condition improves after stopping trastuzumab.
For a few people, however, it may be permanent.
Your heart will be checked before and during treatment with trastuzumab to help ensure there are no problems.
Adopting a lifestyle that includes a healthy diet, regular exercise and for those who smoke, quitting smoking may help protect the heart while taking trastuzumab .
To learn more about trastuzumab, visit the National Institutes of Health’s Medline Plus website.
Some drugs contain biological products such as antibodies. A biosimilar drug is very similar to a brand name drug that contains biological products.
To be approved by the U.S. Food and Drug Administration (FDA), the biosimilar drug must work the same way as the brand name drug and it must have the same :
Biosimilar drugs may cost less than brand name drugs.
The drugs trastuzumab-dkst (Ogivri), trastuzumab-dttb (Ontruzant) and trastuzumab-pkrb (Herzuma) are biosimilar forms of trastuzumab (Herceptin) and can be used to treat HER2-positive breast cancer. They are the only FDA-approved biosimilar drugs for breast cancer treatment at this time.
Other biosimilar drugs for breast cancer are under study.
Pertuzumab (Perjeta) is an antibody that targets HER2-positive cancer cells, but in a different way than trastuzumab.
A randomized clinical trial of women with HER2-positive early breast cancer showed pertuzumab in combination with trastuzumab and chemotherapy after surgery reduced the risk of breast cancer recurrence by about 20 percent .
Pertuzumab is always given in combination with trastuzumab (not on its own). Both drugs are given by vein (through an IV) every 3 weeks for up to 1 year. You will get both drugs at the same time through the same IV (not 2 different IV sessions).
Pertuzumab is also used to treat HER2-positive locally advanced and metastatic breast cancers.
Learn about neoadjuvant (before breast surgery) treatment with pertuzumab and trastuzumab.
Possible side effects of pertuzumab include diarrhea and fatigue .
Pertuzumab may increase the risk of heart problems. Your heart will be checked before and during treatment with pertuzumab to help ensure there are no problems.
To learn more about pertuzumab, visit the National Institutes of Health’s Medline Plus website.
Tyrosine-kinase inhibitors, such as neratinib, are a class of drugs that target enzymes important for cell functions (called tyrosine-kinase enzymes).
These drugs can block tyrosine-kinase enzymes at many points along the HER2 cancer growth pathway.
Neratinib is used to treat HER2-positive early breast cancer in women who have completed treatment with trastuzumab.
A randomized clinical trial showed women who took neratinib had better disease-free survival (survival with no local breast cancer recurrence, metastasis or death from any cause) than women who did not take neratinib .
Neratinib is taken in pill form for 1 year.
The most common side effect of neratinib is diarrhea. Your health care provider will recommend medications to help control the diarrhea .
Other side effects include nausea, abdominal pain, fatigue, vomiting and rash . More serious health risks include liver damage .
To learn more about neratinib, visit the National Institutes of Health’s Medline Plus website.
SUSAN G. KOMEN® SUPPORT RESOURCES
Breast Cancer 101:Targeted Therapy
Facts for Life: Biosimilars
Questions to Ask Your Doctor About Biosimilars
Research Fast Facts: HER2-Positive Breast Cancer
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