Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer


Gastric & Breast Cancer e-journal

DOI: 10.2122/gbc.2008.0080


REVIEW

Targeting HER2 Breast Cancer With Trastuzumab, Lapatinib and Other Novel Agents: Clinical Success and Resistance
Prof. Raimund Jakesz, MD Dr hc
 

Summary

Trastuzumab represents the triumph of translational research. It is the only targeted agent currently used not only in metastatic setting but also in the adjuvant setting saving the lives of patients with HER2-positive early-stage breast cancer.

However, several questions, problems and challenges await solutions. Long-term complete clinical response rate is estimated to be less than 20% because of intrinsic or acquired resistance. Cardiotoxicity, timing, duration and best possible combination with empirical cytotoxic drugs and inefficacy to control brain metastases are further limitations.

Lapatinib, a small-molecule tyrosine kinase inhibitor of both the EGFR and HER2 provides exciting findings alone or in combination with trastuzumab and large-scale phase III clinical trials are underway.

This review articles discusses mechanisms of action and how limitations and hurdles would potentially be overcome for an optimal use trastuzumab, lapatinib, antiangioneic therapy (anti-VEGF) in combinations with modern chemotherapeutic regimens Furthermore, the development of biomarkers to predict response to targeted therapies, in a mean of personalized medicine, is highlighted.

Online ISSN : 1109 - 7647
   Print ISSN : 1109 - 7655

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last update: 3 February 2004