Advanced Therapy Modalities That Have Potential In Overcoming Medication Resistance In HER2-Positive Breast Cancer: In Clinical Scenario

Abstract

Breast cancer, the most common cancer in women worldwide and the leading to cause of death. Approximately 20% of breast cancers due to her2 overexpression and is associated with shorter overall survival and poor prognosis. Tratuzumab, Monoclonal Antibody is the standard care of treatment directed to against the her2 receptor. However, a 3rd of the her2 Positive Breast cancer patients does not respond to therapies. Given the higher rate of resistance, other type of her2-targeted strategies has developed, including monoclonal antibodies such as-Pertuzumab, Margetuximab. Among others, Trastuzumab-based antibody Drug conjugates such as, trastuzumab-emtansine (T-DM1), trastuzumab-deruxtecan (T-DXd), tyrosine kinase inhibitors such as- lapatinib, tucatinib. Moreover, T-DXd has proven to be use of, in the her2-low subclass, which suggests that, in this recently defined new breast cancer subclassification, other her2-targeted therapies could be successful. There are several her2-targeted therapies available, when patients progress to multiple strategies. However, treatment options are limited, and in this era, the potential combination with other drugs, that is still in development, exosomes, immune checkpoint inhibitors, vaccines are an interesting and appealing field. In this review, we will be discussing the pitfalls, highlights of the various her2-targeted therapies, potential combinations to overcome her-2 breast cancer metastatic disease and resistance to therapies.