Targeted therapy

Anti HER2 targeted therapy

Anti-HER2 treatments can only be given to women with HER2-overexpressed breast cancer: 10-15% of breast cancers express a large number of HER2 receptors on their surface. They are called HER2 positive or HER2 overexpressed or HER2 amplified. This is determined by pathological examination of the biopsy or surgical specimen.

Trastuzumab

Trastuzumab (Herceptin®) is an antibody specifically directed against HER2 receptors (human epidermal growth factor receptor 2). It blocks HER2 receptors, preventing the multiplication of cells that carry this receptor. This drug has made a major advance by significantly increasing the cure rate for cancers that have this HER2 receptor. In non-metastatic cancer, it is started almost systematically in combination with chemotherapy, whether the latter is given before or after surgery. It is continued even after chemotherapy is stopped, for a total of one year.

It is also used long-term in patients with HER2 positive metastatic breast cancer.

Pertuzumab

Pertuzumab (Perjeta®) is, like trastuzumab, an antibody specifically directed against HER2 receptors. It has a similar mechanism of action.

It is primarily used in metastatic breast cancer, HER2 overexpressed, as an adjunct to trastuzumab, and in advanced breast cancer.

Trastuzumab-emtansine

Trastuzumab-emtansine T-DM1 (Kadcyla®) is a treatment that combines the anti-HER2 antibody trastuzumab with the chemotherapy drug emtansine. Trastuzumab acts as a key to allow the chemotherapy to enter the tumor cell. It is used after surgery in patients with HER2-overexpressed breast cancer who have not responded to pre-operative chemotherapy with trastuzumab.

It is also used as a second-line treatment in patients with HER2-overexpressed metastatic breast cancer.

Lapatinib

Lapatinib (Tyverb®) belongs to a group of drugs called protein kinase inhibitors. It blocks enzymes known as protein kinases, which include components of the HER2 receptor. By blocking them, it prevents cancer cells from growing.

It is used in metastatic breast cancer, HER2 overexpressed, in case of discontinuation of trastuzumab, pertuzumab and T-DM1.

Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors

Cyclin-dependent kinase inhibitors have become very important in the treatment of hormone-dependent and HER2-negative breast cancer at a metastatic or advanced stage. They act on enzymes, cyclin-dependent kinases 4/6, which play a role in the cell division cycle.

The palbociclib

Palbociclib (Ibrance®) is the standard care in combination with anti-hormonal therapies for the treatment of locally advanced or metastatic hormone receptor sensitive (HR+) and HER2-negative breast cancer.

Ribociclib

Ribociclib (Kisqali®) is also indicated for the treatment of locally advanced or metastatic hormone receptor-sensitive (HR+) and HER2-negative breast cancer, in combination with anti-hormonal therapies.