The scores 1+ and 0 are systematically considered as negative. For the equivocal forms (score 2+), a recourse to in-situ hybridization (ISH) is necessary to rule on the amplification of the HER2 gene. A strong expression in IHC (score 3+) is sufficient. HER2-positive breast cancer is diagnosed by IHC. Approximately 15 percent of breast cancers overexpress human epidermal growth factor receptor 2 (HER2). The objective of this article was to review data on the established drugs and novel agents for HER2-positive MBC and to discuss how to incorporate anti-HER2 therapies in first and later-line settings.īreast cancer is the leading cause of cancer-related mortality among females in the world. Tucatinib is a new tyrosine kinase inhibitor that has given hope for the treatment of these patients. ![]() Despite the benefits of these antidrug conjugates, this benefit in patients with brain metastases remains unclear. ![]() However, trastuzumab–deruxtecan has become a new standard. ![]() Very recently, the development of a new antidrug conjugate, trastuzumab–deruxtecan, has improved the overall survival of patients, even in second-line treatment. Currently, the combination of anti-HER2 double blockade and taxane and trastuzumab emtansine (T-DM1) are considered the standard treatments for metastatic breast cancer overexpressing these receptors in the first and second line. For several years, the overexpression of the HER2 receptor in breast cancer has been correlated with a poor prognosis and an increased risk of developing brain metastases.
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