Biology and Treatment of HER2-Low Breast Cancer

Hematol Oncol Clin North Am. 2023 Feb;37(1):117-132. doi: 10.1016/j.hoc.2022.08.013.

Abstract

Current guidelines recommend a dichotomous classification of HER2 as either positive or negative, to guide clinicians in treatment decisions. Until now, only patients with HER2-positive breast cancer (BC) had been demonstrated to derive clinical benefit from anti-HER2 therapies. However, novel ADCs have recently emerged, with activity in the large population of patients with HER2-low-expressing BC. Although it remains unclear whether HER2-low BC represents a distinct entity, given the therapeutic implication its crucial to accurately distinguish HER2-low from HER2-0 BC. Efforts are needed to standardize HER2 testing in BC and to introduce more sensitive assays to better discriminate HER2 levels.

Keywords: Antibody-drug conjugates; Breast cancer; HER2-low; Human epidermal growth factor receptor 2; Immunohistochemistry; Trastuzumab deruxtecan.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Biology
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / genetics
  • Female
  • Humans
  • Molecular Targeted Therapy
  • Receptor, ErbB-2

Substances

  • Receptor, ErbB-2
  • Antineoplastic Agents