2019 Nov 15;125(22):3974-3984. doi: 10.1002/cncr.32392. They do know that you canât get a copy of the HER2 gene from your parents and you canât pass it on to your children. Federal government websites often end in .gov or .mil. It’s also important to follow recommended screening guidelines, which can help detect certain cancers early. The field of HER2+ breast cancer, particularly for BrM, continues to evolve as new therapeutic strategies show promising results in recent clinical trials. Trastuzumab emtansine versus treatment of physicians choice in patients with previously treated HER2-positive metastatic breast cancer (TH3RESA): final overall survival results from a randomised open-label phase 3 trial. Cases of human epidermal growth factor receptor 2 (HER2)-positive breast cancer represent approximately 15% to 20% of all breast cancers. November 2011. doi: 10.1186/1477-7819-9-146. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. Theyâre not sure why the cells grow faster in some people and not in others. Read our, Treatments for HER2-Positive Breast Cancer, HER2 Positive vs. HER2 Negative Breast Cancer, Breast Cancer and Metastasis to the Brain, Navigating Treatment Options for Metastatic Breast Cancer, Overview of Triple-Positive Breast Cancer, (Early to Advanced) Breast Cancer Treatment by Stage, Enhertu for Breast Cancer: Benefits, Side Effects, and Cost, How HER2-Negative Breast Cancer Is Treated. Previous preclinical data has helped elucidate HER2 brain trophism, the blood-brain/blood-tumor barrier(s), and the brain tumor microenvironment, all of which can lead to development of novel therapeutic options. Preclinical Efficacy of Ado-trastuzumab Emtansine in the Brain Microenvironment. Trastuzumab emtansine with or without pertuzumab versus trastuzumab with taxane for human epidermal growth factor receptor 2-positive advanced breast cancer: Final results from MARIANNE. 2015 Nov 7;108(2):djv313. 2. HER2-positive breast cancer typically develops due to an overproduction of the HER2 gene. The American Cancer Society can help you. WebMD does not provide medical advice, diagnosis or treatment. and transmitted securely. For those who have been treated with Perjeta and T-DM1 and still progressed, options include the combination of Xeloda (capecitabine) and the targeted therapy Tykerb (lapatinib), hormonal therapy for those who have estrogen-receptor-positive tumors, and other chemotherapy regimens in combination with HER2-targeted drugs. 8600 Rockville Pike Treatment of Stage IV (Metastatic) Breast Cancer. Obtenga más información sobre los tipos de tratamiento contra el cáncer de mama en hombres en una guía diferente de este sitio web (en inglés). Currently, the first-line standard of care for patients with HER2-positive metastatic breast cancer is dual HER2 antibody therapy with pertuzumab/trastuzumab plus a taxane. -, Tsukada Y, Fouad A, Pickren JW, Lane WW. Talk to family and friends and let them know how you are feeling. FDA Approves Treatment to Prevent Hearing Loss in Children with Cancer, U.S. Department of Health and Human Services. Gao YK, Kuksis M, Id Said B, Chehade R, Kiss A, Tran W, Sickandar F, Sahgal A, Warner E, Soliman H, Jerzak KJ. These cancers tend to grow and spread faster than breast cancers that are HER2-negative, but are much more likely to respond to treatment with drugs that target the HER2 protein. Credit: World J Surg Oncol. Unable to load your collection due to an error, Unable to load your delegates due to an error, Suggested algorithm for multidisciplinary management of care for patients with HER2+ breast cancer brain metastases. These cells then stay in other areas of the body. To describe the treatment effect on the development and progression (CNS progression) of BM in participants without baseline BM using additional efficacy measurements. To describe the effect of T-DXd on symptoms, functioning, and health-related quality of life (HRQoL) in HER2+ MBC participants with or without baseline BM. Targeted therapy. About 15% to 20% Lindsay Cook, PharmD is a board-certified consultant pharmacist. Background: Brain metastases (BrM) incidence is 25% to 50% in women with advanced human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Your medical team can help learn more about your cancer. The blood-brain barrier is a collection of tightly knit capillaries that prevents many toxins and medications, including many chemotherapy drugs, from accessing the brain. "Los resultados de estos . When lapatinib is combined with chemotherapy, however, the response rates are better.. BMJ Supportive & Palliative Care. Metastatic (stage 4) HER2-positive breast cancer is not curable—but it is treatable, and options continue to expand and improve. Food and Drug Administration. Future Oncol. Available Every Minute of Every Day. PMC Read our, Treating Metastatic HER2-Positive Breast Cancer, HER2 Positive vs. HER2 Negative Breast Cancer. Informativa estesa sull’utilizzo dei cookie 1983;52(12):2349‐2354. Nearly all of the more than 180 women in the trial had at least some reduction in the size of their tumors, with 61% experiencing substantial reductions, Dr. Krop reported. When only a few metastases are present, treating these with surgery or SBRT may be considered, but studies have not yet shown an increased survival rate from this practice.. 2022 Nov 23;14(23):5754. doi: 10.3390/cancers14235754. Dr. Krop called the results “compelling,” noting that the tumor response rate is “roughly double or triple what we typically see in other studies of this third- or later-line [patient] population.”. These are treatments that specifically address the area to which the cancer has spread. Breast cancer cells with higher than normal levels of HER2 are called HER2-positive . To describe efficacy in participants with stable or untreated BM. The CNS PFS is defined as time from the first dose of study intervention to CNS progression per CNS RECIST 1.1 or death resulting from any cause, whichever occurs first. This protein is also in breast tissue . Nel nostro paese circa 40.000 donne vive con un carcinoma mammario metastatico; il 15-20% delle pazienti hanno tumori che iper-esprimono la proteina Her2. Epub 2021 Sep 21. All rights reserved. In many cases, the exact reason why HER2-positive breast cancer starts is unknown, although there have been some connections made between risk factors and being diagnosed with breast cancer. Breast cancer cells with strong HER2 amplification (red) that have spread to the lymph nodes. To describe the treatment effect on the development and progression of BM in participants with or without baseline BM using additional efficacy measurements. 2019 Nov;143:20-26. doi: 10.1016/j.critrevonc.2019.07.010. For example, tucatinib (Tukysa) is for people with advanced HER2-positive breast cancer. Treatments used for HER2-positive breast cancer target that protein specifically and block it to slow the growth of the cancer. at the National Institutes of Health, An official website of the United States government. For general information, Learn About Clinical Studies. National Comprehensive Cancer Network (NCCN). -, Arvold ND, Oh KS, Niemierko A, et al. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. FDA’s approval of trastuzumab deruxtecan included a special warning for clinicians on the risk of the lung-related side effects, known as interstitial lung disease (ILD). Triple-positive breast tumors are HER2-positive, ER-positive, and PR-positive. El tratamiento consiste en 6 sesiones de quimio (de la más dura, según palabras de la oncóloga), 1 año de inmunoterapia, radioterapia (aún no . UpToDate. Abeloff’s Clinical Oncology. Two new treatment options are emerging for women with metastatic breast cancer, following positive results from clinical trials. FDA’s approval of trastuzumab deruxtecan came approximately 2 months after AstraZeneca had filed its approval application. This is called a mastectomy. Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These breast cancers are still being studied but appear to benefit from certain HER2-targeted drugs. That selectivity limits the risk of side effects seen with other HER2-targeted TKIs that inhibit other targets, Dr. Lipkowitz said. The introduction of trastuzumab dramatically . doi: 10.1200/GO.22.00126. Approximately 500 eligible participants will be enrolled into 1 of 2 cohorts (250 participants in each cohort) according to the presence or absence of BMs at baseline. Perez EA, Barrios C, Eiermann W, Toi M, Im YH, Conte P, Martin M, Pienkowski T, Pivot XB, Burris HA 3rd, Petersen JA, De Haas S, Hoersch S, Patre M, Ellis PA. Cancer. 2022 Sep;8:e2200126. As such, the diagnosis often comes as a shock to many. Listing a study does not mean it has been evaluated by the U.S. Federal Government. A 2017 review of the literature found that Herceptin (trastuzumab) clearly improves survival for those with HER2-positive breast cancer with brain metastases. To describe the treatment effect on the development and progression of BM in participants with or without baseline BM using additional efficacy measurements. Lytic or mixed lytic bone lesions that can be assessed by CT or MRI or X-ray in the absence of measurable disease as defined above is acceptable; Participants with sclerotic/osteoblastic bone lesions only in the absence of measurable disease are not eligible; and Non-measurable CNS disease (Cohort 2 only), Adequate organ and bone marrow function within 14 days before the day of first dosing as defined in the protocol, Left ventricular ejection fraction ≥ 50% within 28 days before enrollment, Negative pregnancy test (serum) for women of childbearing potential, Known or suspected leptomeningeal disease, Refractory nausea and vomiting, chronic gastrointestinal disease, or previous significant bowel resection that would preclude adequate absorption, distribution, metabolism, or excretion of T-DXd, History of another primary malignancy except for malignancy treated with curative intent with no known active disease within 3 years before the first dose of study intervention and of low potential risk for recurrence, Based on screening contrast brain MRI/CT scan, participants must not have any of the following: any untreated brain lesions > 2.0 cm in size; ongoing use of systemic corticosteroids for control of symptoms of BMs; any brain lesion thought to require immediate local therapy; have poorly controlled (> 1/week) generalized or complex partial seizures, or manifest neurologic progression due to BMs not withstanding CNS-directed therapy, Known active hepatitis B or C infection, such as those with serologic evidence of viral infection within 28 days of Cycle 1 Day 1. In a 2018 study, palliative mastectomy was found to improve quality of life for some people. CNS metastases in breast cancer. This is why a biopsy and re-checking receptor status is so important if you have a distant recurrence of your disease. That finding led the study’s leaders to stress that clinicians need to watch carefully for lung disease in women who receive the drug and take the appropriate measures to manage it. Below are some of the resources we provide. If you have some risk factors for developing breast cancer, keep in mind the things you can do to help reduce your personal risk, including exercising regularly, eating a nourishing diet, and maintaining a healthy weight. For future studies of the drug, Dr. Krop said, clinicians will be advised to carefully monitor patients for any evidence or symptoms of ILD and, if they suspect it has developed, to immediately stop the drug and treat the patient with steroids. The American Cancer Society medical and editorial content team. Version 7.2021 – August 23, 2021. The site is secure. La combinación de docetaxel, trastuzumab y pertuzumab se convirtió en el estándar de tratamiento de primera línea para las pacientes con cáncer de mama avanzado HER2-positivo tras los resultados del estudio CLEOPATRA, que objetivó un beneficio significativo en supervivencia global (57,1 frente a 40,8 meses) con la incorporación de . Suggested algorithm for multidisciplinary management…, Suggested algorithm for multidisciplinary management of care for patients with HER2+ breast cancer…, MeSH HER2 significa receptor 2 del factor de crecimiento epidérmico humano. Historically, this subtype of breast cancer was associated with an increased risk for the development of systemic and brain metastases and poor overall survival. HER2-positive breast cancer: new therapeutic frontiers and overcoming resistance. The American Cancer Society is a qualified 501(c)(3) tax-exempt organization. About 20% of breast cancers are HER2-positive. Borges VF, Ferrario C, Aucoin N, Falkson C, Khan Q, Krop I, Welch S, Conlin A, Chaves J, Bedard PL, Chamberlain M, Gray T, Vo A, Hamilton E. JAMA Oncol. Tincknell G, Naveed A, Nankervis J, Mukhtiar A, Piper AK, Becker TM, Chantrill L, Aghmesheh M, Vine KL, Ranson M, Brungs D. Cancers (Basel). These extra proteins signal the cancer cells to grow out of control. Curr Oncol Rep. 2015 Oct;17(10):46. doi: 10.1007/s11912-015-0471-z. The agency had granted the application a “priority review,” which is used to expedite the assessment of drugs it believes have the potential to be a significant improvement for the treatment of life-threatening conditions. An Open-Label, Multinational, Multicenter, Phase 3b/4 Study of Trastuzumab Deruxtecan in Patients With or Without Baseline Brain Metastasis With Previously Treated Advanced/Metastatic HER2-Positive Breast Cancer (DESTINY-Breast12). Estos cánceres tienden a crecer y propagarse más rápido que otros tipos de cáncer de seno, pero responden al tratamiento con medicamentos que tienen como blanco a la proteína HER2. Of note is that the complications of bone metastases, such as fractures, become extra important as many of the treatments for breast cancer can lead to bone loss. That’s important, explained Jesus Anampa, M.D., who specializes in the treatment of breast cancer at the Montefiore Medical Center in New York. It's thought that giving the most active treatments as soon as possible can improve survival in HER2-positive metastatic breast cancer.. 2022 Dec 16;11(1):105. doi: 10.1186/s40164-022-00349-z. Doctors donât know exactly what causes HER2-positive breast cancer. En tu informe patológico, se incluirá información sobre el estado para HER2 del cáncer. Donât miss any appointments, and reach out to your doctor whenever you have questions. In: DeVita VT, Lawrence TS, Lawrence TS, Rosenberg SA, eds. Even so, less than 6% of patients in the tucatinib group stopped treatment because of side effects. TRAF4 hyperactivates HER2 signaling and contributes to Trastuzumab resistance in HER2-positive breast cancer. Print 2016 Feb. Crit Rev Oncol Hematol. Making Strides Against Breast Cancer Walks, Breast Cancer Ploidy and Cell Proliferation, Other Breast Cancer Gene, Protein, and Blood Tests, Imaging Tests to Find Out if Breast Cancer Has Spread, Questions to Ask Your Doctor About Breast Cancer, Testing Biopsy and Cytology Specimens for Cancer, Understanding Your Pathology Report: Breast Cancer, If the IHC result is 0, the cancer is considered, If the IHC result is 1+, the cancer is considered, If the IHC result is 2+, the HER2 status of the tumor is not clear and is called ". Es posible que haya aprendido que tiene cáncer de mama en estadio 4 (metastásico) cuando se le diagnosticó la enfermedad por primera vez, pero con mayor frecuencia, las metástasis a distancia ocurren como una recurrencia de un tumor que inicialmente fue un tumor en etapa temprana años antes. Le pazienti con metastasi cerebrali, trattate con tucatinib, hanno avuto una riduzione del rischio di morte del 42 % con una sopravvivenza a 2 anni del 48,5%; la percentuale di risposte cerebrali è più che raddoppiata (47,3% versus 20%); il farmaco si è dimostrato altamente efficace anche nelle pazienti mai trattate localmente per malattia cerebrale. Patterns of breast cancer second recurrences in patients after mastectomy. Can Shoulder Pain Be a Symptom of Breast Cancer? They are HER2-, ER-, and PR-negative. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf on August 31, 2021. But unlike with early-stage breast cancer—in which several options (surgery, chemotherapy, radiation, etc.) Nadie lo va a hacer por tí. Before More than 600 participants were randomly assigned to receive either a commonly used third-line treatment regimen, the chemotherapy drug capecitabine and trastuzumab, along with a placebo, or treatment with the capecitabine‒trastuzumab duo and tucatinib. Cohort 1 will include participants without BM at baseline and Cohort 2 will consist of participants with BM at baseline. Bookshelf It looks for extra copies of the HER2 gene, which make the HER2 protein. Background: In contrast, Tykerb (lapatinib) appears to have little effect on brain metastases and has a high toxicity profile. Chen WW, Chu TSM, Xu L, Zhao CN, Poon WS, Leung GK, Kong FS. Radiation is also a popular choice when cancer has spread to the brain. Dual HER2 blockade with pertuzumab (P) and trastuzumab (T) in patients with HER2-positive metastatic breast cancer (mBC) relapsing after adjuvant treatment with T: results from a German non-interventional study (NIS) HELENA (NCT01777958). Hormone therapy. Gu Y, Gao H, Zhang H, John A, Zhu X, Shivaram S, Yu J, Weinshilboum RM, Wang L. Oncogene. Would you like email updates of new search results? In this review, we analyze the management strategies for metastatic HER2-positive breast cancer, address specific situations, such as the treatment of patients with brain metastases, and discuss future directions in the treatment of this subtype. Finding the best treatment sequencing for each patient, developing reliable predictive biomarkers, and understanding the mechanisms of resistance to these drugs are necessary to maximize patient outcomes and quality of life. Why Should I Register and Submit Results? The time to next progression is defined as the time from the date of the first documented isolated CNS progression to the date of the next documented disease progression (CNS or extracranial) per RECIST 1.1 or death, and will be summarized descriptively in participants who develop isolated CNS progression, receive local therapy, and continue on protocol therapy. After progression, the standard of care is trastuzumab emtansine (T-DM1). Studies a U.S. FDA-regulated Drug Product: Studies a U.S. FDA-regulated Device Product: Product Manufactured in and Exported from the U.S.: Objective Response Rate (ORR) in Participants without BM at Baseline (Cohort 1) [ Time Frame: From screening until progression of disease [PD] (Up to 2.5 Years) ], Progression-free Survival (PFS) in Participants with BM at Baseline (Cohort 2) [ Time Frame: From screening until PD (Up to 2.5 Years) ], Overall Survival (OS) in Months [ Time Frame: At safety F/U (40+7 days after last dose) visit, thereafter survival F/U q3months ± 14 days (Approximately 2.5 Years) ], Duration of Response (DoR) [ Time Frame: Screening Day (-28 days) until end-of-treatment (EOT) (Approximately 2.5 Years) ], Time to Progression [ Time Frame: Screening Day (-28 days) until PD (Approximately 2.5 Years) ], Duration of Treatment on Subsequent Lines of Therapy [ Time Frame: At safety follow-up (40+7 days after last dose) then survival F/U q3months ± 14 days (Approximately 2.5 Years) ], Time to Second Progression or Death (PFS2) [ Time Frame: At safety F/U (40+7 days after last dose) visit, thereafter survival F/U q3months ± 14 days (Approximately 2.5 Years) ], Incidence of new Symptomatic Central Nervous System (CNS) Metastasis During Treatment in Participants without BM at Baseline (Cohort 1) [ Time Frame: At Screening day (-28 days), Cycle 1 (15 days ± 2 days) Day 1 and Cycle 3 (15 days ± 2 days) Day 1 and thereafter every 3 subsequent cycles (Approximately 2.5 Years) ], Time to Next Progression (CNS or extracranial) or Death [ Time Frame: Screening Day (-28 days) until next PD (Approximately 2.5 Years) ], Site (CNS vs extracranial vs both) of Next Progression [ Time Frame: Screening Day (-28 days) until next PD (Approximately 2.5 Years) ], Objective Response Rate in Participants with BM at Baseline (Cohort 2) [ Time Frame: From screening until PD (Up to 2.5 Years) ], Central Nervous System Progression-free Survival in Participants with BM at Baseline (Cohort 2) [ Time Frame: At safety follow-up (40+7 days after last dose) then survival F/U q3months ± 14 days (Approximately 2.5 Years) ], Time to new CNS Lesions in Participants with BM at Baseline (Cohort 2) [ Time Frame: Screening Day (-28 days) until EOT (Approximately 2.5 Years) ], Central Nervous System Objective Response Rate in Participants with BM at Baseline by ICR (Cohort 2) [ Time Frame: Screening Day (-28 days) until EOT (Approximately 2.5 Years) ], Central Nervous System Duration of Response in Participants with BM at Baseline (Cohort 2) [ Time Frame: Screening Day (-28 days) until EOT (Approximately 2.5 Years) ], European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) [ Time Frame: Cycle 1 (15 days ± 2 days) Day 1, thereafter every 3 weeks (q3w) until 24 weeks post EOT visit and prior to second progression, and at the EOT visit (Approximately 2.5 Years) ], Neurologic Assessment in Neuro-Oncology Scale [ Time Frame: Cycle 1 (15 days ± 2 days [Day 1]), Cycle 2 (15 days ± 2 days) Day 1, Cycle 3 (15 days ± 2 days) Day 1, Cycle 4 (15 days ± 2 days) Day 1 thereafter subsequent Cycles until PD and at EOT visit (Approximately 2.5 Years) ], Cognitive Functions Tests [ Time Frame: Cycle 1 (15 days ± 2 days) Day 1, thereafter q12w and at EOT visit (Approximately 2.5 Years) ], MD Anderson Symptom Inventory Brain Tumor-specific Items [ Time Frame: Cycle 1 (15 days ± 2 days) Day 1, thereafter q3w until 24 weeks post EOT visit and prior to second progression, and at the EOT visit (Approximately 2.5 Years) ], St. George's Respiratory Questionnaire - idiopathic pulmonary fibrosis version in Participants with Interstitial Lung Disease (ILD)/Pneumonitis [ Time Frame: After diagnosis of ILD/pneumonitis and thereafter once weekly until EOT and safety F/U (40+7 days after last dose) (Approximately 2.5 Years) ], Number of Participants with Adverse Events [ Time Frame: Cycle 1 (15 days ± 2 days) Day 1 until safety F/U (40+7 days after last dose) (Approximately 2.5 Years) ], Number of Participants with Investigator-assessed ILD/Pneumonitis or Rate of Investigator-assessed ILD/Pneumonitis [ Time Frame: Cycle 1 (15 days ± 2 days) Day 1 until C4 (15 days ± 2 days) Day 1 and thereafter subsequent cycles until PD (Approximately 2.5 Years) ], Number of Participants with Adverse Events with BM at Baseline [ Time Frame: Cycle 1 (15 days ± 2 days) Day 1 until safety F/U (40+7 days after last dose) (Approximately 2.5 Years) ], Participants should have pathologically documented breast cancer that is: unresectable/advanced or metastatic; confirmed HER2-positive status expression as determined according to American Society of Clinical Oncology/College of American Pathologists guidelines, Participant must have either: no evidence of BM, or untreated BM on screening contrast brain magnetic resonance imaging/ computed tomography (MRI/CT) scan, not needing immediate local therapy or previously-treated stable or progressing BM, Participants with BMs must be neurologically stable. HER2-Positive Gastroesophageal Cancers Are Associated with a Higher Risk of Brain Metastasis. Asimismo, el tratamiento doi: 10.1002/onco.13965. Brain metastases (BrM) incidence is 25% to 50% in women with advanced human epidermal growth factor receptor 2 (HER2)-positive breast cancer. There are different types of these drugs that work in different ways. Trastuzumab deruxtecan, meanwhile, is one of a class of drugs called antibody‒drug conjugates (ADCs), which consist of a monoclonal antibody chemically linked to a cell-killing drug. Cancer Reports published by Wiley Periodicals LLC. Un nuevo fármaco oral, llamado Camizestrant, ha demostrado que reduce "de forma significativa" el riesgo de progresión del tumor en pacientes con cáncer de mama. For participants requiring radiotherapy due to BMs, there should be an adequate washout period before day of first dosing: ≥ 7 days since stereotactic radiosurgery or gamma knife, Eastern Cooperative Oncology Group performance status 0-1, Previous breast cancer treatment: radiologic or objective evidence of disease progression on or after HER2 targeted therapies and no more than 2 lines/regimens of therapy in the metastatic setting, Participant with the following measurable: at least 1 lesion that can be accurately measured at baseline as ≥ 10 mm in the longest diameter with CT or MRI and is suitable for accurate repeated measurements; or following Non-measurable diseases: Non-measurable, bone-only disease that can be assessed by CT or MRI or X-Ray. Verywell Health's content is for informational and educational purposes only. Clipboard, Search History, and several other advanced features are temporarily unavailable. Ask your doctor about your HER2 status and what it means for you. HER2-positive breast cancer means that the breast cancer cells have extra HER2 (human epidermal growth factor receptor 2) proteins on the outside of them. Askoxylakis V, Ferraro GB, Kodack DP, Badeaux M, Shankaraiah RC, Seano G, Kloepper J, Vardam T, Martin JD, Naxerova K, Bezwada D, Qi X, Selig MK, Brachtel E, Duda DG, Huang P, Fukumura D, Engelman JA, Jain RK. That said, treatments that are "metastasis-specific" may be used as well. Radiation. 8600 Rockville Pike In about 1 of every 5 breast cancers, the cancer cells have extra copies of the gene that makes the HER2 protein. government site. Chemotherapy. may be used in combination to prevent recurrence, if possible—such treatment of stage 4 breast cancer doesn't improve survival. Although the treatment choices for patients whose disease has progressed on these agents are more limited, promising new drugs have emerged as effective options, including tucatinib and trastuzumab deruxtecan, which were recently approved by the US Food and Drug Administration. HER2-positive breast cancer typically develops due to an overproduction of the HER2 gene. The drug is approved for use in combination with trastuzumab (Herceptin) and capecitabine (Xeloda) by patients whose cancer cannot be removed surgically or has spread to other parts of the body (metastasized) and who have undergone at least one prior line of treatment. Epub 2019 Aug 12. Tarantino P, Prat A, Cortes J, Cardoso F, Curigliano G. Biochim Biophys Acta Rev Cancer. Las pruebas de HER2 pueden mostrar si usted tiene un cáncer HER2 positivo. But many women in the study who received the drug saw their tumors shrink and lived for an extended period without their cancer getting worse. Cáncer de mama metastásico HER2 positivo. Bhargava P, Rathnasamy N, Shenoy R, Gulia S, Bajpai J, Ghosh J, Rath S, Budrukkar A, Shet T, Patil A, Desai S, Nair N, Joshi S, Popat P, Wadasadawala T, Pathak R, Sarin R, Kannan S, Badwe R, Gupta S. JCO Glob Oncol. Under an accelerated approval, the drug’s manufacturer, Daiichi Sankyo, and AstraZeneca, with which it has a global commercialization agreement, must conduct further studies of trastuzumab deruxtecan to confirm that it benefits patients. The American Cancer Society offers programs and services to help you during and after cancer treatment. Nearly 30 months after treatment, people who received tucatinib, trastuzumab, and capecitabine lived for a median of about 21.6 months, compared with 12.5 months for people receiving only trastuzumab and capecitabine. See this image and copyright information in PMC. Disclaimer, National Library of Medicine It can be very stressful to have cancer. 2022 Oct 31;6(4):147. doi: 10.31579/2692-9392/147. 2020;70(1):7‐30. "Son necesarias más opciones de tratamiento para retrasar la progresión de la enfermedad y prolongar la supervivencia en pacientes con cáncer de mama metastásico HER2 positivo que desarrollan metástasis cerebrales," asegura Susan Galbraith, MBBChir, PhD, Executive Vice President, Oncology R&D de AstraZeneca. Drugs. They may perform a procedure called a lumpectomy to get rid of: In some cases, your doctor might remove the entire breast. To describe efficacy in participants with stable or untreated BM. government site. Living Beyond Breast Cancer: âHER2-Positive Breast Cancer.â, UpToDate: âPatient education: Treatment of early HER2-positive breast cancer (Beyond the Basics).â, Moffitt Cancer Center: âWhat Causes HER2 Positive Breast Cancer?â âHER2 Positive Breast Cancer Symptoms,â âHER2 Positive Breast Cancer Treatment Optionsâ, Penn Medicine Abramson Cancer Center: âHER2-Positive Breast Cancer.â, Cancer.net: âBreast Cancer - Metastatic: Types of Treatment.â, American Cancer Society: âBreast Cancer HER2 Status,â âFind Support Programs and Services in Your Area.â. Nella maggior parte dei casi il carcinoma Entre el 30% y el 50% de las pacientes con cáncer de mama avanzado HER2 positivo desarrollan metástasis en el cerebro, que permanecen estables mientras responden a las terapias locales. For those who have previously been treated with Herceptin, another HER2-targeted drug may be used. HER2 helps breast cells grow and multiply. The https:// ensures that you are connecting to the 2022 Jun 25;14(13):3119. doi: 10.3390/cancers14133119. 2018 Sep 1;4(9):1214-1220. doi: 10.1001/jamaoncol.2018.1812. This protein promotes the growth of cancer cells. Mucho ánimos a todas. “But it’s a great opportunity to offer patients some options they currently don’t have,” she said. Tucatinib Combined With Ado-Trastuzumab Emtansine in Advanced ERBB2/HER2-Positive Metastatic Breast Cancer: A Phase 1b Clinical Trial. Participants with or without BM at baseline will receive intravenous (IV) T-DXd, 5.4 mg/kg, every 3 weeks (21-day cycle) until Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) defined radiological progression outside central nervous system, unacceptable toxicity, withdrawal of consent, or another criterion for discontinuation is met. Early results from this study showed that approximately 45% of women in the trial had a tumor response to the drug. 2004;22(14):2865‐2872. The lingering mysteries of metastatic recurrence in breast cancer. HER2 (breast cancer) testing. Nella maggior parte dei casi il carcinoma mammario metastatico non è suscettibile di guarigione ma è una malattia che può essere tenuta sotto controllo per lunghi periodi. How to Determine a Breast Cancer Prognosis, Causes and Risk Factors of Male Breast Cancer, Enhertu for Breast Cancer: Benefits, Side Effects, and Cost, How HER2-Negative Breast Cancer Is Treated, Breast Cancer Vaccine Shows Promise in Early Human Trial. New strategies driven by and focusing on brain metastasis-specific genomics, immunotherapy, and preventive strategies have shown promising results and are under development. Trastuzumab often goes along with chemotherapy or hormonal therapy. Third-line treatment of HER2-positive advanced breast cancer: From no standard to a Pandora's box. Breast Cancer Res Treat. By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. In addition, targeted therapies tend to have far fewer side effects than chemotherapy drugs. An official website of the United States government. Please enable it to take advantage of the complete set of features! Breast cancer can spread to many other distant regions of the body as well, including the skin, muscle, fatty tissue, and bone marrow. The time to new CNS lesions is defined as the time from the date of the first dose of study intervention to the date of documented new CNS lesions. Breast Cancer Res Treat. Triple-negative breast tumors don’t have too much HER2 and also don’t have estrogen or progesterone receptors. Study record managers: refer to the Data Element Definitions if submitting registration or results information. No de los mejores según he podido descubrir, aunque parece que de los que más ha avanzando la investigación (el llamado Herceptin). Epub 2019 Jul 18. For those who haven't yet been treated with T-DM1, this drug is an option. HER2-positive breast cancer has been shown to potentially relapse or metastasize sooner after treatment than other types of . When you first find out you have breast cancer, your doctor will do several tests to learn more about it. Breast cancer clinical trials often exclude women whose cancer has spread to the brain, but more than 25% of women with metastatic HER2-positive breast cancer will develop brain metastases, Dr. Anampa said. The approval applies to patients whose cancer has spread to the brain, which occurs in more than 25% of people with metastatic HER2-positive breast cancer and is typically very difficult to treat. If a cancer has progressed on Herceptin or within 12 months of stopping the drug, trastuzumab emtansine (T-DM1) is the preferred option second-line. Comparison of stereotactic body radiotherapy versus metastasectomy outcomes in patients with pulmonary metastases. HER2 es una proteína de las células de los senos. Ecancermedicalscience. If you have not previously been treated with a HER2-targeted drug, treatment is usually started with Herceptin (trastuzumab) or Perjeta (pertuzumab). Everyday Habits to Lower Breast Cancer Risk, Eating Well During Breast Cancer Treatment, What You Need to Know About Breast Cancer Treatment, Redness or a thickening in your breast or nipple. Radiation and surgery are currently the main local treatment approaches for central nervous system (CNS) metastases. Enhertu label. Clinical Profile and Outcome of Patients With Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer With Brain Metastases: Real-World Experience. These cancers are treated with hormone drugs as well as drugs that target HER2. Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update. CC BY 2.0. Women in the tucatinib group lived a little more than 2 months longer without their cancer getting worse (median of 7.8 months versus 5.6 months), an outcome known as progression-free survival, than women in the capecitabine‒trastuzumab alone group. Information provided by (Responsible Party): This is open-label, multicenter, international study, assessing the efficacy and safety of Trastuzumab deruxtecan (T-DXd) in participants with or without brain metastasis (BMs), with previously-treated advanced/metastatic HER2-positive breast cancer whose disease has progressed on prior anti-HER2-based regimens and who received no more than 2 lines/regimens of therapy in the metastatic setting (excluding tucatinib). Brain metastasis as the first and only metastatic relapse site portends worse survival in patients with advanced HER2 + breast cancer. To describe the treatment effect on the development and progression of BM in participants with or without baseline BM using additional efficacy measurements. Third line options will vary depending on prior treatments. Often, doctors give it before surgery, after surgery, or both. El término "HER2" puede referirse al gen HER2 o a la proteína HER2, que produce el gen. Las proteínas HER2 son. Even so, 15% of the participants stopped taking the drug because of side effects. First line treatment for metastatic breast cancer depends largely on receptor status, and if it is a recurrence, both your estrogen and progesterone receptor status and HER2/neu status should be tested. ¿Cómo se evalúa el estado de HER2 de los tumores del seno? They usually grow quicker than other types of cancer. Tax ID Number: 13-1788491. American Cancer Society. Thorac Cancer. In the late 1990s, trastuzumab was among the first targeted cancer therapies to be approved by FDA, after trials showed it could improve survival in women with metastatic HER2-positive breast cancer. Accessibility At the American Cancer Society, we’re on a mission to free the world from cancer. FOIA Interviene en el crecimiento normal de las células. Medline Plus. J Natl Cancer Inst. Deruxtecan is a type of chemotherapy drug called a topoisomerase I inhibitor, Dr. Krop said during an SABCS press briefing, but it is far more potent than other topoisomerase I inhibitors. | ISSN 2499-6599, Informativa estesa sull’utilizzo dei cookie. When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool. Pernas S, Tolaney SM. Duration of treatment on subsequent therapy will be defined as the time from the date of first dose of a subsequent therapy until date of the last dose of that therapy. 2020 Nov;80(17):1811-1830. doi: 10.1007/s40265-020-01411-y. Kai M, Kubo M, Kawaji H, et al. These are treatments that specifically address the area to which the cancer has spread. When breast cancer spreads from outside of the breast to distant areas of the body, such as the liver, brain, bones, or lung, it is called metastatic breast cancer. Individual Participant Data (IPD) Sharing Statement: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. If thatâs the case with your cancer, you can take drugs to lower your levels or block how estrogen works in your body. HHS Vulnerability Disclosure, Help Based on the DESTINY-Breast01 results, in fact, on December 20, the Food and Drug Administration (FDA) announced an accelerated approval for trastuzumab deruxtecan as a treatment for women with previously treated HER2-positive breast cancer. Accessibility . Estos cánceres se denominan "HER2-positivo" y tienen muchas copias del gen HER2 o niveles altos de la proteína HER2. Radiation and surgery are currently the main local treatment approaches for central nervous system (CNS) metastases. Las dimensiones eran 86x90mm, tuve primero quimioterapia para tratar de reducir el tamaño del bulto, 9 sesiones de quimioterapia cada 21 dias, el . Site of next progression will be summarized descriptively in participants who develop isolated CNS progression, receive local therapy, continue on protocol therapy, and have a subsequent documented disease progression (CNS or extracranial) per RECIST 1.1. Breast Care (Basel). Oncotarget. Ther Adv Med Oncol. Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. doi:10.1111/1759-7714.12880, By Lynne Eldridge, MD Immunohistochemistry (IHC) test. At least one of those tests will check to see if your cancer is HER2-positive. Noteware L, Broadwater G, Dalal N, Alder L, Herndon Ii JE, Floyd S, Giles W, Van Swearingen AED, Anders CK, Sammons S. Breast Cancer Res Treat. The efficacy of tucatinib-based therapeutic approaches for HER2-positive breast cancer. NCI CPTC Antibody Characterization Program, Siegel RL, Miller KD, Jemal A. “Why we have this particular risk is unclear,” he said. Growth factors bind to these receptor proteins on breast cancer cells, causing the growth characteristic of these tumors. HER2 is a protein that helps breast cancer cells grow quickly. 2017;11:715. doi:10.3332/ecancer.2017.715. Treatment is decided on accordingly, and an approach for metastases of breast cancer to any site usually involves hormonal drugs, HER2-positive-targeted therapies, or chemotherapy.. Epub 2022 Oct 26. An OS is defined as the time from the date of the first dose of study intervention until death due to any cause. Breast Cancer Vaccine Shows Promise in Early Human Trial, First line treatment for metastatic breast cancer, Treatment of Stage IV (Metastatic) Breast Cancer, HER2-positive breast cancer: new therapeutic frontiers and overcoming resistance, Trastuzumab emtansine versus treatment of physicians choice in patients with previously treated HER2-positive metastatic breast cancer (TH3RESA): final overall survival results from a randomised open-label phase 3 trial, QOL-enhancing surgery for patients with HER2-positive metastatic breast cancer, Bone metastasis risk factors in breast cancer, Breast cancer subtypes predict the preferential site of distant metastases: a SEER based study, Systemic Treatment Options for HER2-Positive Breast Cancer Patients with Brain Metastases beyond Trastuzumab: A Literature Review, Comparison of stereotactic body radiotherapy versus metastasectomy outcomes in patients with pulmonary metastases. Epub 2022 Nov 20. In particular, the findings with tucatinib in women with brain metastases “are really impressive,” he said. The lingering mysteries of metastatic recurrence in breast cancer. En las pacientes con un cáncer de mama metastásico, del subtipo HER2-positivo, el estado de expresión de los receptores hormonales, la localización de las metástasis y la edad se han identificado como factores que influyen en su supervivencia, según el estudio RegistEM que desvela nuevos datos sobre las pacientes y la evolución de este cáncer avanzado. sharing sensitive information, make sure you’re on a federal J Clin Oncol. Epub 2022 Sep 22. Given the generally aggressive and rapid growth of HER2-positive tumors and the need to uniquely target the human epidermal growth factor receptor 2 (HER2) protein to be most effective, this is promising. Ask for help when you need it or tell them when you just want to talk. C. K. A.: Research funding PUMA, Lilly, Merck, Seattle Genetics, Nektar, Tesaro, G1‐Therapeutics; Compensated consultant role: Genentech, Eisai, IPSEN, Seattle Genetics; Astra Zeneca; Royalties: UpToDate, Jones and Bartlett. Which treatment do you think is best for me? Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing. From mammograms to living after treatment. The results of several ongoing phase 3 clinical trials of this drug will help oncologists better understand how trastuzumab deruxtecan should be used in clinical practice, he continued. Itâs usually in the form of high-energy X-rays. Here you'll find in-depth information on specific cancer types – including risk factors, early detection, diagnosis, and treatment options. 11th ed. This site needs JavaScript to work properly. Oncologist. Lung metastases from breast cancer are primarily treated with general measures to treat the breast cancer, such as hormonal therapies, HER2-targeted drugs, and chemotherapy, rather than any specific treatments. Bethesda, MD 20894, Web Policies “And clearly we need to do more … research to identify those patients who are at risk of getting the most severe cases of ILD and [learn] how to mitigate the risk.”. This can cause breast cells to grow faster than normal. UPDATE: On April 17, 2020, the Food and Drug Administration (FDA) approved tucatinib (Tukysa) to treat people with HER2-positive advanced breast cancer. Other HER2-targeted TKIs include neratinib (Nerlynx) and lapatinib (Tykerb). Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Krop IE, Kim S-B, Martin AG, et al. With ADCs, the antibody component serves as a homing device, guiding the linked drug to cancer cells. Epub 2022 Jul 21. Please remove one or more studies before adding more. La principal conclusión del estudio DESTINY-Breast03, presentado en uno de los simposios del Congreso de la European Society for Medical Oncology (ESMO) de 2021,¹ fue que el tratamiento con trastuzumab deruxtecán, un fármaco-anticuerpo dirigido a cáncer de mama HER2, aprobado para pacientes con cáncer de mama metastásico HER2 positivo avanzado, se asocia a una mejora estadística y . 6th ed. 2022 Dec;196(3):583-589. doi: 10.1007/s10549-022-06772-4. Since that time, other targeted drugs that target HER2 have been developed, leaving options even when one drug (or even two) fails.. It will take time to see how these drugs will affect patients, Dr. Nahleh acknowledged. The trials tested the drugs tucatinib and trastuzumab deruxtecan (Enhertu) in women who had been previously treated for metastatic breast cancer that overproduces the HER2 protein, known as HER2-positive breast cancer. Questo inibitore delle tirosin chinasi è sufficientemente piccolo da attraversare la barriera ematoencefalica e raggiungere il cervello, bloccando direttamente lo stimolo di proliferazione della proteina Her2. There are genes that increase the risk of developing breast cancer that can be passed from parents to their children. Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the metropolitan Detroit cancer surveillance system. Jagsi R, King TA, Lehman C, Morrow M, Harris JR, Burstein HJ. Females who have never had a baby or have had a baby after the age of 30 have an increased risk of developing breast cancer. En los estudios clínicos del cáncer de seno, a menudo se excluyen a las mujeres cuyo cáncer se diseminó al cerebro, pero más del 25 % de las mujeres con cáncer de seno metastásico positivo para HER2 presentarán metástasis cerebrales, dijo el doctor Anampa. They target specific tissue types, genes, or proteins that play a part in cancer growth. Riggio AI, Varley KE, Welm AL. These cancers are called HER2-positive breast cancers. J Clin Oncol. Several anti-HER2 agents are currently available and reviewed here, some of which have recently shown promising effects in BrM patients, specifically. Moffit Cancer Center. Some TKIs have multiple targets. When cancer spreads, incredibly small cells escape from the original tumor and travel through the body via the lymphatic system or the blood vessels. Preliminary findings from the phase III trial (SOPHIA) found that people who had received several treatments for metastatic HER2-positive cancer had better progression-free survival when treated with the investigational monoclonal antibody margetuximab than with the combination of Herceptin and chemotherapy. Bethesda, MD 20894, Web Policies These HER2 receptors can signal the cancer cells to grow quickly and out of control. HER2-positivo. 2022 Nov;196(2):311-321. doi: 10.1007/s10549-022-06710-4. How well treatments work depends on how much the cancer has spread and which other therapies you've tried. Thill M, Wimberger P, Grafe A, Klare P, Luedtke-Heckenkamp K, Reichert D, Zaiss M, Ziegler-Löhr K, Eckl T, Schneeweiss A. Increasing inclusion of patients with BrM in clinical studies, and a focus on assessing their outcomes both intracranially and extracranially, is changing the landscape for patients with HER2+ CNS metastases by demonstrating the ability of newer agents to improve outcomes. As such, both tucatinib and trastuzumab deruxtecan could meet an important need, Dr. Lipkowitz said, because there is no proven third-line treatment for metastatic HER2-positive breast cancer. You may have learned that you have stage 4 (metastatic) breast cancer when you were first diagnosed with the disease, but more commonly, distant metastases occur as a recurrence of a tumor that was initially an early-stage tumor years earlier. by Edward Winstead, November 2, 2022, This is open-label, multicenter, international study, assessing the efficacy and safety of Trastuzumab deruxtecan (T-DXd) in participants with or without brain metastasis (BMs), with previously-treated advanced/metastatic HER2-positive breast cancer whose disease has progressed on prior anti-HER2-based regimens and who received no more than 2 lines/regimens of therapy in the metastatic setting . Tucatinib, on the other hand, is a member of a class of drugs known as tyrosine kinase inhibitors (TKIs). Severe diarrhea was also more frequent in women treated with tucatinib. The clinical trial leading to tucatinib’s approval, called HER2CLIMB, is described in the post below. This uses a group of drugs made specifically for HER2-positive breast cancer. © 2020 The Authors. Breast cancer HER2 status. Which ones your doctor will give you depend on which treatments you've already tried. Cancer.org is provided courtesy of the Leo and Gloria Rosen family. Until 1998, when Herceptin was approved, HER2-positive tumors had a poorer prognosis, especially for those who also had estrogen- and progesterone-receptor-negative tumors. If there are only a few sites of metastasis (oligometastases), surgical removal or stereotactic body radiotherapy (SBRT) can improve survival. Perjeta may also be used for those who have not yet received it in combination with Herceptin. Systemic Therapy for HER2-Positive Central Nervous System Disease: Where We Are and Where Do We Go From Here? Dado el crecimiento generalmente agresivo y rápido de los tumores positivos para HER2 y la necesidad de dirigirse de manera única a la proteína del receptor del factor de crecimiento epidérmico humano 2 (HER2) para que sea la más efectiva, esto es . They think that your environment, lifestyle, and genes can all play a part. To describe the treatment effect on the development and progression of BM in participants without baseline BM using additional efficacy measurements. Other treatments such as embolization may be considered as well. See Testing Biopsy and Cytology Specimens for Cancer and Understanding Your Pathology Report: Breast Cancer to get more details about these tests. Brain Cancer Cells Hijack Gene “On Switches” to Drive Tumor Growth, Enfortumab Vedotin Approved for Recurrent Bladder Cancer, If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. Another ADC, trastuzumab emtansine (Kadcyla), or T-DM1, is already a standard treatment for metastatic HER2-positive breast cancer. Although men can be diagnosed with breast cancer, the majority of breast cancer patients are female. View this study on Beta.ClinicalTrials.gov, U.S. Department of Health and Human Services. Br J Cancer. In one of the trials, called HER2CLIMB, women treated with tucatinib in addition to trastuzumab (Herceptin) and capecitabine lived longer both without their disease progressing and overall than women who received only trastuzumab and capecitabine (Xeloda). El ensayo ha sido coordinado de forma internacional por Mafalda Oliveira , investigadora del Hospital Vall d . Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Breast cancers that are HER2-positive tend to be aggressive, with the excess HER2 protein on tumor cells fueling the cancer’s growth. This site needs JavaScript to work properly. In women whose cancer had spread to the brain, which accounted for about 45% of trial participants, approximately 25% were still alive without their disease progressing 1 year after beginning treatment, compared with 0% in the other treatment group. J Clin Oncol. When breast cancer is metastatic at the time of diagnosis, surgery has not usually been done, as it was believed that it didn't improve survival rates. Targeting HER2 in Breast Cancer: Latest Developments on Treatment Sequencing and the Introduction of Biosimilars. doi:10.18632/oncotarget.15856. Most of the time, these distant metastases are treated with general treatment for metastatic HER2-positive cancer, but when isolated metastases occur, options such as surgery or radiation therapy may be considered. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Seniors Taking Multiple Meds: Itâs a Complicated Problem, 3 COVID Scenarios That Could Spell Trouble for the Fall, Colonoscopy Benefits Lower Than Expected (Study), Dr. Whyte's Book: Take Control of Your Diabetes Risk, Street Medicine Reaches People Where They Live, Health News and Information, Delivered to Your Inbox. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Also: Keep up with your doctor visits. NCI CPTC Antibody Characterization Program. Four of the women who developed ILD died as a result. Henry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Chapter 88: Cancer of the Breast. Concurrent use of hormonal therapy for noncancer- related conditions is allowed, Unresolved toxicities from previous anticancer therapy, defined as toxicities (other than alopecia) not yet resolved to Grade ≤ 1 or baseline, Palliative radiotherapy with a limited field of radiation within 2 weeks or with wide field of radiation, radiation to the chest, or to more than 30% of the bone marrow within 4 weeks before the first dose of study intervention, Participants with prior exposure to immunosuppressive medication within 14 days prior to first study dose, Participants with a known hypersensitivity to study intervention or any of the excipients of the product or other monoclonal antibodies. It is not clear if one test is more accurate than the other, but FISH is more expensive and takes longer to get the results. doi: 10.1093/jnci/djv313. We’ve invested more than $5 billion in cancer research since 1946, all to find more – and better – treatments, uncover factors that may cause cancer, and improve cancer patients’ quality of life. Systemic Treatment Options for HER2-Positive Breast Cancer Patients with Brain Metastases beyond Trastuzumab: A Literature Review. Epub 2020 Nov 28. Choosing to participate in a study is an important personal decision. Laakmann E, Müller V, Schmidt M, Witzel I. Whether you or someone you love has cancer, knowing what to expect can help you cope. Klaas E, Mohamed S, Poe J, Reddy R, Dagra A, Lucke-Wold B. Arch Med Case Rep Case Study. Ca‐Cancer J Clin. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019. Innovative Approaches for Breast Cancer Metastasis to the Brain. If your tumor is both estrogen-receptor-positive and HER2-positive, initial treatment may include hormonal therapy, a HER2-targeted therapy, or both. Together, we’re making a difference – and you can, too. What Is Metastatic HER2-Positive Breast Cancer?
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