Journal
FRONTIERS IN PHARMACOLOGY
Volume 13, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fphar.2022.1089066
Keywords
breast cancer; HER2-positive; tyrosine kinase inhibitors; novel combinations; clinical practice
Categories
Funding
- Efficacy/standardization technology development of marine healing resources and its life cycle safety management of Korea Institute of Marine Science and Technology Promotion (KIMST) - Ministry of Oceans and Fisheries
- Cooperative Research Program for Agriculture Science and Technology Development Rural Development Administration, Republic of Korea [KIMST-20220027]
- [PJ01701902]
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Breast cancer is a heterogeneous disease caused by epigenetic modifications and genetic heterogeneity. HER2+ breast cancer is a more aggressive subtype with difficult diagnosis and prognosis. Various targeted therapies have been developed, but drug resistance and limited efficacy remain challenges. Nano formulations show potential in the treatment of HER2+ breast cancer.
Breast cancer (BC) is caused by epigenetic modifications and genetic heterogeneity and exhibits various histological feature. HER2+ (Human epidermal growth factor receptor 2) is a more aggressive type of breast cancer, diagnosis and prognosis are difficult for HER2+ BC. Anti-HER2+ inhibitors have been effectively used for patient treatment. High mortality rate is reported in HER2+ BC, due to availability of limited therapeutic options. Despite advances in systemic medications to treat metastatic breast cancer (MBC), HER2-positive MBC is still challenging for patients and treating clinicians. The clinical characteristics of the disease have changed after treatment with HER2-targeted therapy. Various types of Tyrosine kinase inhibitors (TKIs) have been developed to treat patients with HER2+ BC including afatinib, lapatinib, neratinib, tucatinib, and pyrotinib, have been developed as HER2-targeted therapies. The antibody-drug conjugates adotrastuzumab, emtansine, famtrastuzumab, and deruxtecan, as well as the anti-HER2 monoclonal antibody pertuzumab are used in both early-stage and metastatic situations, either alone or in conjunction with chemotherapy and other HER2-targeting therapies. The emergence of drug resistance in antiHER2 therapies has been observed. To overcome drug resistance and limited efficacy in current treatment options, nano formulations can be used in patients with HER2+ BC treatment. Anti-HER2 ligands can be used in various nano formulations to target HER2 receptors. Here we will discuss, targeted TKIs in patients with HER2+ BC, clinical studies of HER2+ targeted TKIs, mechanisms of resistance to HER2-directed therapies with new implications of TKIs in HER2+ MBC (metastatic breast cancer) and anti-HER2 ligand in various nano formulations to target HER2 receptors.
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