[Frontiers in Bioscience S4, 31-42, January 1, 2012]

Which role for EGFR therapy in breast cancer?

Vito Lorusso1, Rosachiara Forcignano1, Saverio Cinieri2, Andrea Tinelli3, Letizia Porcelli4, Anna Elisa Quatrale4, Vincenzo Emanuele Chiuri1

1Medical Oncology Unit, Hospital Vito Fazzi, Lecce, Italy, 2Medical Oncology Unit, Hospital Perrino, Brindisi, Italy, 3Department of Gynaecology and Obstetrics, Vito Fazzi Hospital, Lecce, Italy, 4Clinical Experimental Oncology Laboratory, National Cancer Institute "Giovanni Paolo II", Viale Orazio Flacco, 65 - 70124 Bari, Italy

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. HER2-targeted agents in the metastatic setting
3.1. Trastuzumab monotherapy
3.2. Chemotherapy in combination with Trastuzumab
3.3. Lapatinib trials in first-line therapy
3.4. HER2-targeted agents after progression on Trastuzumab
4. HER2-targeted agents in the adjuvant setting
5. HER23-targeted agents in the neoadjuvant setting
6. HER2-targeted agents: cardiotoxicity
7. New agents and new combinations to target HER2
8. Conclusions
9. References

1. ABSTRACT

EGFR and HER2 are highly expressed in 15-30% of breast cancer tissues. Therefore, EGFR and its downstream signaling pathways are promising anti-tumour targets. HER2 overexpression is often associated with estrogen receptor (ER) and progesterone receptor (PR) negativity, high histological grade, high rates of cell proliferation and lymph node involvement. Moreover, it is correlated with disease aggressiveness, increased rates of recurrence and poorer survival in node-positive breast cancer patients, whereas the prognostic significance in patients with node-negative tumors remains somewhat controversial. This paper focuses on the therapeutic strategy for treatment of HER2 overexpressing breast cancer in advanced stages of disease, as well as in the adjuvant and neo-adjuvant settings.