BJMO - 2024, issue 4, june 2024
K. Punie MD, G. Jerusalem MD, PhD, I. Deleu MD, A. Gombos MD, T. Feys MBA, MSc, F.P. Duhoux MD, PhD
HER2 overexpression has been a therapeutic target in breast cancer (BC) for many years and the development of anti-HER2 therapies has markedly improved the outcome of patients exhibiting high levels of HER2 expression. In this, the HER2 status of patients was traditionally defined in a binary fashion, in which patients with high levels of HER2 expression were classified as HER2-positive, while all the rest were denominated as HER2-negative. Despite being classified as HER2-negative; the majority of these BCs do express some level of HER2. Until recently, however, these low levels of HER2 expression did not have any therapeutic implications. This has changed with the publication of the DESTINY-Breast04 (DB-04) study in which trastuzumab deruxtecan (T-DXd) was shown to significantly improve the progression-free (PFS) and overall survival (OS) of patients with HER2-low metastatic BC. These findings require a recalibration of the treatment paradigm for patients with advanced BC. Furthermore, the increased interest in HER2-low BC led to questions on the biology, epidemiology, heterogeneity, and prognostic relevance of HER2-low disease and confronts physicians with the challenge of incorporating the treatment of HER2-low disease in the rapidly evolving treatment landscape for patients with hormone-receptor-positive (HR+) and triple-negative BC (TNBC).
(BELG J MED ONCOL 2024;18(4):141–51)
Read moreBJMO - volume 13, issue 3, may 2019
G. El Hachem MD, Y. Jounblat MD, A. Awada MD, PhD, A. Gombos MD
Triple-negative breast cancer is a heterogeneous subtype of breast carcinoma lacking the expression of oestrogen, progesterone and human epidermal growth factor 2 receptors. For many decades, cytotoxic chemotherapy has been the standard of care offering only a short-living disease control. Knowing its poor outcome and aggressive behaviour, researchers are trying to find new therapeutic options hoping to improve the survival of this population. Many cytotoxic and targeted therapies were tested without major benefit. However, in the era of molecular and mutational classification of tumours, as well as the immune mediated mechanisms of proliferation and progression, the trials are currently oriented towards the identification of potential targets in the tumoral heterogenic environment. Here, we present a review of literature concerning the potential anti-neoplastic options and novel therapies for metastatic triple-negative breast cancers: new cytotoxic agents, new targeted therapies, anti-angiogenic agents, antibody-drug conjugates, poly-ADP ribose transferase inhibitors and immunotherapy. Many agents are promising, yet not powerful enough to get approvals for use into clinical practice.
(BELG J MED ONCOL 2019;13(3):84–92)
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