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Predictive Value of c--erb-B2 for Endocrine Therapy and Chemotherapy in Breast Cancer

  • Vered Stearns
Part of the Cancer Drug Discovery and Development book series (CDD&D)

Abstract

c-erb-B2, also designated HER-2/neu or c-neu, is a tyrosine kinase proto-oncogene that may be overexpressed or amplified in 20–40% of breast tumors. Data reported to date suggest that the proto-oncogene may be a predictive factor of response to several therapies that are commonly used to treat breast cancer. Tumors that are both hormone receptors and c-erb-B2 positive may be associated with a relative resistance to tamoxifen. Preliminary data suggest that aromatase inhibitors may be more effective in such tumors. Available data suggest that women with c-erb-B2-positive tumors may have a preferential response to anthracycline-containing regimens compared to cyclophosphamide, methotrexate, 5-fluorouracil (CMF)-like regimens. Anthracycline-based therapy should be recommended to women with c-erb-B2-positive breast cancer unless there is a contraindication to the administration of this group of agents. However, other regimens should not be withheld from women who cannot receive an anthracyline. Current clinical data also suggest a possible sensitivity to taxane-based therapy, especially when combined with an anthracycline. Trastuzumab-based therapy should be considered as first line therapy for women with metastatic breast cancer with c-erb-B2-positive disease who are hormone receptor negative, or those with hormone receptor-positive disease who have progressed on endocrine treatments. Adjuvant trastuzumab should be considered in women with high-risk primary breast cancer.

Key Words

c-erb-B2 HER-2/neu predictive factor hormone therapy chemotherapy trastuzumab 

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Copyright information

© Humana Press Inc., Totowa, NJ 2006

Authors and Affiliations

  • Vered Stearns
    • 1
  1. 1.The Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins UniversityBaltimoreUSA

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