c-erbB-2 in breast cancer: development of a clinically useful marker

Semin Oncol. 2002 Jun;29(3):231-45. doi: 10.1053/sonc.2002.32899.


c-erbB-2 amplification and/or overexpression occurs in 20% to 30% of breast cancers and appear to be associated with a more aggressive phenotype. Detecting abnormalities in c-erbB-2 might provide important clinical information for breast cancer patients. However, several of the potential clinical uses of c-erbB-2 remain unproven. Many variables influence c-erbB-2 results, including selection and characteristics of test populations and methods of analysis. Current literature suggests two roles for c-erbB-2, either as a pure prognostic factor with no association with therapy or as a factor predictive of benefit from specific types of systemic treatments. c-erbB-2 appears to be only a weak prognostic factor, although some individual studies suggest greater prognostic importance. c-erbB-2 abnormalities appear to predict for relative, but not absolute, resistance to endocrine therapy in estrogen receptor (ER)-positive women. When adjuvant chemotherapy is indicated, some studies have indicated that patients with c-erbB-2-positive cancers (by immunohistochemistry [IHC] or fluoresence in situ hybridization [FISH]) receive more benefit from anthracycline-containing regimens as compared to alkylating agents. c-erbB-2 testing appears critical for selecting patients with metastatic disease who should receive the anti-c-erbB-2 antibody, trastuzumab. Prospective randomized clinical trials of trastuzumab as adjuvant therapy are underway. Well-designed, prospective, randomized clinical trials (designed to test the value of c-erbB-2) or formal meta-analyses will help to better establish the predictive role of c-erbB-2 in breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents / therapeutic use
  • Biomarkers, Tumor / metabolism*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / prevention & control
  • Humans
  • Predictive Value of Tests
  • Prognosis
  • Receptor, ErbB-2 / metabolism*
  • Trastuzumab


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Receptor, ErbB-2
  • Trastuzumab