Treatment for HER2-positive breast cancer depends on tumor size and spread but may involve a combination of chemotherapy, targeted therapy, monoclonal antibody therapy, and kinase inhibitors.
HER2 stands for human epidermal growth factor receptor 2. It is a gene that makes the HER2 protein. The HER2 protein is found on the surface of healthy cells and allows for normal cell growth and division.
Too many HER2 receptors on breast cancer cells can lead to the rapid growth of a breast cancer tumor.
When researchers discovered that the HER2 gene had links to breast cancer growth, it led to the development of treatments that have significantly improved the survival rates for people with HER2-positive breast cancer.
Read on to learn more about the treatments for HER2-positive breast cancer.
The treatment plan for HER2-positive breast cancer will
There have been significant advances in systemic therapies for HER2-positive breast cancers. This means that people with early stage and metastatic HER2-positive breast cancers have some treatment options.
Monoclonal antibodies
Monoclonal antibody treatments stop cancer from growing by attaching to the HER2 protein on cancer cells. Monoclonal antibody medications include:
- Trastuzumab (Herceptin): This medication can help treat early or advanced stage HER2 breast cancer. People may receive trastuzumab in combination with chemotherapy.
- Pertuzumab (Perjeta): Doctors administer this medication with Herceptin and chemotherapy.
- Margetuximab (Margenza): Doctors use this medication to treat advanced-stage HER2-positive breast cancer. They may recommend it with chemotherapy when other targeted treatments are ineffective.
Learn more about monoclonal antibodies.
Antibody drug conjugates
Antibody drug conjugates are a combination of chemotherapy and a monoclonal antibody. They attach to the HER2 protein and help the chemotherapy work more effectively. They include:
- Ado-trastuzumab emtansine (Kadcyla): Oncologists use Kadcyla in the adjuvant setting after surgery if there is residual disease in the breast and if a person has had neoadjuvant treatment.
- Fam-trastuzumab deruxtecan (Enhertu): People may receive Enhertu if they have cancer that has spread to other parts of the body or cancer that doctors cannot remove surgically.
Learn about adjuvant and neoadjuvant treatment.
Kinase inhibitors
A kinase is a protein that prompts cells to take specific actions. HER2 is a type of kinase that tells a cell to grow. Kinase inhibitors work by blocking the action of HER2. Kinase inhibitors are oral medications such as:
- Lapatinib (Tykerb): Doctors often use lapatinib (Tykerb) in combination with chemotherapy for advanced breast cancer.
- Neratinib (Nerlynx): People may receive neratinib (Nerlynx) for early stage cancer after surgery and chemotherapy. Doctors may also recommend it along with chemotherapy for cancer that has spread to other parts of the body.
- Tucatinib (Tukysa): People may receive tucatinib (Tukysa) for advanced breast cancer after completing another targeted treatment.
Learn more about anti-HER2 drugs and metastatic breast cancer.
Surgeons may be able to remove all of the HER2-positive breast cancer tumor, particularly in the early stage when it has not spread to other parts of the body.
However, this type of breast cancer is more aggressive than HER2-negative breast cancer. It is more likely to grow, spread to other parts of the body, or return after treatment.
HER2-positive breast cancer may be curable in some cases. A person’s doctor can provide more information about whether they believe the cancer is curable based on their circumstances.
Learn about the treatments for HER2-positive breast cancer.
Many variables can affect life expectancy after a cancer diagnosis, such as tumor size, whether the cancer has spread, and how effective treatment is.
An early diagnosis typically means a person has more treatment options and better outcomes.
Doctors use 5-year relative survival rates to estimate life expectancy. These survival rates compare how likely it is that someone with a type of cancer will still be alive 5 years after diagnosis compared to someone without cancer.
Whether the HER2-positive breast cancer is hormone receptor negative (HR-) or positive (HR+) will slightly affect life expectancy.
According to the
For regional cancer, the 5-year relative survival rate is 90.4% for HR-positive and HER2-positive and 84.2% for HR-negative and HER2-positive cancer.
If cancer has spread to another part of the body, the 5-year relative survival rates are 45.8% for HR-positive and HER2-positive cancer and 39.7% for HR-negative and HER2-positive cancer.
Learn about HER2-negative breast cancer.
A person who has received a diagnosis of breast cancer will likely have many questions about their treatment options.
Being informed about the treatment plan is important. Here are some questions a person with a diagnosis of HER2-positive breast cancer may want to ask a doctor:
- What are the treatment options?
- What are the pros and cons of each treatment approach?
- How long will treatment last?
- What is the plan to know whether a treatment is working or not?
- How will the decision be made about whether a different treatment is necessary?
- Are there any clinical trials currently recruiting for this type of cancer?
Learn about the first-line treatment for breast cancer.
Effective targeted treatments exist for HER2-positive breast cancer. They work by blocking the action of HER2 genes to stop cancer growth.
Doctors consider HER2-positive breast cancers more aggressive, often requiring a multi-modality approach to care, including surgery, systemic therapy, and radiation therapy.
Survival rates for this type of breast cancer are generally good, particularly when a person receives a diagnosis and starts treatment early on.
People can discuss their treatment options with their doctor and learn more about their outlook based on their circumstances.