Therapeutic strategies and mechanisms of tumorigenesis of HER2-overexpressing breast cancer

Crit Rev Oncol Hematol. 2012 Dec;84 Suppl 1(Suppl 1):e49-57. doi: 10.1016/j.critrevonc.2010.09.002. Epub 2010 Oct 15.

Abstract

The receptor tyrosine kinase HER2 is overexpressed in approximately 25% of breast cancers. HER2 acts as a signal amplifier for its siblings, namely three different transmembrane receptors that collectively bind with 11 distinct growth factors of the EGF family. Thus, overexpression of HER2 confers aggressive invasive growth in preclinical models and in patients. Specific therapies targeting HER2 include monoclonal antibodies, antibody-drug conjugates, small molecule tyrosine kinase inhibitors, as well as heat shock protein and sheddase inhibitors. Two of these drugs have shown impressive - yet mostly transient - efficacy in patients with HER2 overexpressing breast cancer. We highlight the biological roles of HER2 in breast cancer progression, and overview the available therapeutic armamentarium directed against this receptor-kinase molecule. Focusing on the mechanisms that confer resistance to individual HER2 targeting agents, we envisage therapeutic approaches to delay or overcome the evolvement of resistance in patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antinematodal Agents / pharmacology
  • Antinematodal Agents / therapeutic use*
  • Breast / drug effects
  • Breast / metabolism
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / metabolism
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Lapatinib
  • Molecular Targeted Therapy / methods*
  • Quinazolines / pharmacology
  • Quinazolines / therapeutic use*
  • Receptor, ErbB-2 / antagonists & inhibitors
  • Receptor, ErbB-2 / genetics
  • Receptor, ErbB-2 / metabolism*
  • Trastuzumab
  • Up-Regulation

Substances

  • Antibodies, Monoclonal, Humanized
  • Antinematodal Agents
  • Quinazolines
  • Lapatinib
  • Receptor, ErbB-2
  • Trastuzumab