Addressing Residual Disease in HER2-Positive and Triple-Negative Breast Cancer: What Is Next?

Curr Oncol Rep. 2024 Apr;26(4):336-345. doi: 10.1007/s11912-024-01501-0. Epub 2024 Feb 23.

Abstract

Purpose of review: To summarize the treatment strategies for patients with human epidermal growth factor receptor 2 (HER2)-positive disease and triple-negative breast cancer (TNBC) who have residual disease after preoperative systemic therapy.

Recent findings: There has been a shift towards neoadjuvant systemic therapy for selected patients with HER2-positive and TNBC. Assessing the tumor's response to therapy provides prognostic information and allows individualization of the postoperative treatment for these patients based on the tumor response to neoadjuvant therapy. Patients with TNBC with residual disease after neoadjuvant therapy can be treated with pembrolizumab, capecitabine, or olaparib. Those with HER2-positive disease are treated with adjuvant trastuzumab emtansine. The treatment of early breast cancer has evolved significantly, and patient outcomes continue to improve. As better treatments are developed, we will need biomarkers to determine which patients may benefit from certain therapies to continue to improve outcomes by right-sizing treatments and limiting toxicities.

Keywords: Adjuvant therapy; Breast cancer; Capecitabine; Neoadjuvant therapy; Olaparib; Pembrolizumab; T-DM1.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ado-Trastuzumab Emtansine / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms* / drug therapy
  • Female
  • Humans
  • Neoadjuvant Therapy
  • Receptor, ErbB-2 / metabolism
  • Treatment Outcome
  • Triple Negative Breast Neoplasms* / drug therapy
  • Triple Negative Breast Neoplasms* / genetics

Substances

  • Ado-Trastuzumab Emtansine
  • Receptor, ErbB-2