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HER2 is the target of the monoclonal antibody trastuzumab (marketed as Herceptin). Trastuzumab is effective only in cancers where HER2 is over-expressed. One year of trastuzumab therapy is recommended for all patients with HER2-positive breast cancer who are also receiving chemotherapy. [33] Twelve months of trastuzumab therapy is optimal.
In early-stage HER2-positive breast cancer, trastuzumab-containing regimens improved overall survival (Hazard ratio (HR) = 0.66) and disease-free survival (HR = 0.60). [38] Increased risk of heart failure (RR = 5.11) and decline in left ventricular ejection fraction ( relative risk RR = 1.83) were seen in these trials as well. [ 38 ]
HER2-low has some HER2 proteins on the cell surface, but not enough to be classified as HER2-positive. [4] Trastuzumab deruxtecan is the first approved therapy by the US Food and Drug Administration (FDA) targeted to people with the HER2-low breast cancer subtype. [4] DNA-based classification.
Staging breast cancer is the initial step to help physicians determine the most appropriate course of treatment. As of 2016, guidelines incorporated biologic factors, such as tumor grade, cellular proliferation rate, estrogen and progesterone receptor expression, human epidermal growth factor 2 (HER2) expression, and gene expression profiling into the staging system.
HER2-positive tumors may be treated with the targeted medical therapy (e.g., trastuzumab). Further information: Breast cancer management and Breast cancer § Management Treatment of non-metastatic invasive breast cancer can vary based on staging, usually early stage (stages I and II) versus locally advanced (stage III).
The five-year survival rates in England and the United States are between 80 and 90%. [16] [4] [5] In developing countries, five-year survival rates are lower. [2] Worldwide, breast cancer is the leading type of cancer in women, accounting for 25% of all cases. [17] In 2018, it resulted in two million new cases and 627,000 deaths. [18]
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