Current Status Of Anti
Professor Liu Guangyu, Fudan University Cancer Hospital, has pointed out that, there is a lack of large-scale data on our anti-HER2 treatment of HER2-positive breast cancer patients. A 2011 study published in the Journal of Cancer Research China reported data on the anti-HER2 therapy for HER2-positive breast cancer patients in the Beijing area in 2008 the results showed that only 20% HER2-positive patients received a targeted therapy. A 2014 study published in the Lancet Oncology also showed that, in spite of trastuzumab being listed in China in 2002, only 20.6% of HER2-positive breast cancer patients received the anti-HER2 therapy in Beijing .
To further understand the current status of anti-HER2 therapy in breast cancer patients and fight for the benefit of survival for patients, CBCS launched a large-scale survey named the Goddess Project . The study carried out a nationwide survey on the rate of adjuvant anti-HER2 targeted therapy for HER2-positive breast cancer patients, including summary analysis of the rate of targeted treatment to factors of patient age, TNM stage, and hormone receptor expression.
Annual Hazard Rate Of Lrr
Figure 4 shows the annual LRR patterns of the three groups in the entire cohort, HR+ cohort, and HR cohort. Visual inspection of the LRR hazard curves showed a difference in LRR patterns between the HER2 group and HER2+ + T group and HER2+ T group. In the entire cohort, the annual hazard rate of LRR in the HER2+ T group was consistently higher than that in the HER2 group or HER2+ + T group. The annual LRR curve of the HER2+ T group displayed an obvious double-peaked pattern, with an early peak at ~2.5 years and a late peak at ~9 years. The annual LRR curve of the HER2+ + T group displayed a single early peak at ~2.5 years. The annual LRR curve of the HER2 group displayed a continuously low risk without an obvious peak . The observed difference in LRR among these three groups occurred mainly during the first 5 years rather than beyond 5 years. The annual LRR rate of HER2, HER2+ + T, and HER2+ T groups was 1.4%, 1.3% and 3.0% during the first 5 years , and 0.5%, 0.4% and 1.9% after 5 years , respectively.
Figure 4 Annual hazard rates for locoregional recurrence of the entire group , HR-positive patients , and HR-negative patients grouped according to HER2 status and trastuzumab treatment. HR, hormonal receptor-negative HR+, hormonal receptor-positive HER2, HER2-negative HER2+ + T, HER2-positive with trastuzumab HER2+ T, HER2-positive without trastuzumab.
Up To 20% Of Breast Cancers Are Due To Her2
HER2 or human epidermal growth factor receptor 2 refers to the HER2 gene and its associated protein. The protein helps to control the growth of healthy cells. But if the HER2 gene is amplified, or the protein is over-expressed, the cells can grow uncontrollably and lead to cancer.
Up to 20% of invasive breast cancers are a result of HER2 gene amplification or overexpression of HER2 protein.
The two trials behind the study were supported by the National Cancer Institute. Funds for the long-term follow-up study came from National Institutes of Health grants, the Breast Cancer Research Foundation, Genentech and the Cancer and Leukemia Group B.
In July 2014, Medical News Today reported how researchers discovered a new target for the treatment of a particularly aggressive breast cancer. The molecule concerned known as v6 could also identify patients with HER2-positive breast cancer who have a higher risk of developing secondary tumors.
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Prognosis And Survival For Breast Cancer
If you have breast cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
Doctors use different prognostic and predictive factors for newly diagnosed and recurrent breast cancers.
The Details: In Depth Analysis Of The Impact Of Anti
Research data set forth above has illustrated the current status of anti-HER2 therapy in China and in the USA. Will the adoption of targeted therapy for HER2-positive breast cancer affect the survival of patients, and if so, how much is the impact? We will look for answers through clinical data and analysis on real-world treatment conditions.
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Trastuzumab Provides A Comparable Prognosis In Patients With Her2
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Background and Purpose: We investigated the locoregional effect of trastuzumab, and determined whether patients with human epidermal growth factor receptor 2-positive breast cancer treated with trastuzumab could achieve comparable efficacy to that of patients with HER2-negative BC.
Materials and Methods: This was post hoc analyses of data of 793 BC patients from a randomized controlled trial comparing post-mastectomy hypofractionated radiotherapy with conventional fractionated radiotherapy. Survival rates were analyzed by the KaplanMeier method and compared by the log-rank test.
Results: Patients were classified into three groups: HER2-negative , HER2-positve with trastuzumab , and HER2-positive without trastuzumab . The HER2+ + T group had significantly lower locoregional recurrence , distant metastasis and higher disease-free survival at 5 years than that of the HER2+ T group . The HER2 group had significantly lower LRR , DM and higher DFS at 5 years than that of the HER2+ T group . The difference in LRR, DM and DFS at 5 years was not significant between the HER2+ + T group and HER2 group . Different annual LRR patterns was found among groups according to HR status.
Breast Cancer Survival By Age
Five-year survival for female breast cancer shows an unusual pattern with age: survival gradually increases from 85% in women aged 15-39 and peaks at 92% in 60-69 year olds survival falls thereafter, reaching its lowest point of 70% in 80-99 year-olds for patients diagnosed with breast cancer in England during 2009-2013.
Breast Cancer , Five-Year Net Survival by Age, Women, England, 2009-2013
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Availability Of Data And Materials
The dataset analysed in the current study is not publicly available, but was obtained from the Cancer Registry of Norway under a specific ethical approval by the Regional Committee for Medical and Health Research Ethics in the South East Health Region of Norway. Researchers with appropriate approvals can apply for Norwegian health registry data from .
What Are The Symptoms Of Her2
Its not possible to self-determine whether you have HER2-positive breast cancer. If your doctor suspects cancer, further testing will reveal whether you are HER2-positive.
Overall, its important to see your doctor right away if you notice any of the following symptoms:
- any new or changing lumps in your breast or armpit areas
- clear, colored, or bloody nipple discharge
- unexplained pain in your breasts
- changes in your nipples or breast skin, such as dimpling, reddening, or scaliness
- nipples that turn inward
Hormone treatments may be an option for cancer thats also HR-positive.
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Questions To Ask Your Doctor About Her2
- What are my treatment options?
- What is the best course of treatment for my cancer, and why?
- Whats the overall goal of treatment in my case?
- When should I start treatment?
- Can I still work and manage my regular activities during this time?
- How often will I be coming in to see you for treatment?
- Will I be coming here for all my visits and treatments, or going elsewhere?
- What short-term side effects and long-term risks are associated with my treatment?
- What are the next steps if the desired treatment doesnt work?
- How likely is it for my cancer to come back in the future? What symptoms should I be aware of?
- What is the cost of my treatment?
- What should I discuss with my insurance company?
Novel Antibody Drug Conjugates
Following the success and FDA approval of two Antibody Drug Conjugates , there are multiple other agents currently in clinical trials. Like DS-8201, these newer ADCs have a cleavable linker that accounts for what is called the bystander effect. Bystander effect is responsible for the death of antigen-negative cells , hence it is important in both the efficacy and safety of the drug. Here we discuss a few ADCs with published clinical trial results.
These second-generation ADCs are thought to overcome the resistance of HER2+ cells to T-DM1. One of the ADCs currently in clinical trial, SYD985 , was shown to be effective in T-DM1-resistant patient-derived tumor models . Results of the dose-escalation/dose-expansion study with this agent demonstrated clinical activity in heavily pre-treated HER2+ patients, with a partial response of 33% and a median PFS of 7.6 months . Currently, the Phase III randomized TULIP trial is evaluating the drug SYD985 against other standard of care options for previously treated HER2+ breast cancer patients.
Another ADC currently in Phase III trial is BAT8001 , which uses a novel non-cleavable linker between trastuzumab and the maytansine payload. A phase I dose-escalation study revealed the drug to be safe, and it also showed efficacy in heavily pre-treated HER2+ patients. A randomized multi-center Phase III trial is ongoing in China .
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Moffitt Cancer Center Serves Her2 Positive Breast Cancer Survivors
Moffitt Cancer Centers Don & Erika Wallace Comprehensive Breast Program offers advanced monitoring, preventive treatments and supportive care services to women and men with a history of HER2 positive breast cancer, including those who were treated at other hospitals and cancer centers. We encourage you to consult with one of our oncologists specializing in breast cancer if you have any concerns about your risk of recurrence.
Medically reviewed by Dr. Hatem Soliman
Fill out a new patient registration form online or call to reserve an appointment with a Moffitt physician. We encourage women and men with or without referrals to visit us for regular cancer screening and expert breast health advice.
What Causes Her2 Breast Cancer
Researchers are yet to find the cause of HER2 breast cancer. The only thing they know for sure is that HER2 breast cancer isn’t hereditary. You can’t inherit the mutated HER2 gene from a parent.
Possible factors for HER2 breast cancer include:
Age – HER2 breast cancer tends to affect younger women
Hormone replacement therapy use – HER2 is less likely in patients previously on HRT
Alcohol consumption – HER2 positive breast cancer patients are less likely to have used alcohol
Ethnicity Asian and Hispanic individuals have a higher risk of being diagnosed with HER2 breast cancer.
It’s still not clear what causes the HER2 gene to break. However, making appropriate lifestyle changes and participating in regular screening can ensure cancers are detected early.
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Whats The Difference Between Her2
HER2 proteins can indicate whether breast cancer cells are likely to divide and replicate. HER2-negative breast cancer is more common and means that cancer cells are not producing a lot of HER2.
HER2-positive breast cancer, on the other hand, means that the cells are producing a large number of these hormone receptors, indicating a more aggressive cancer.
- having a history of receiving radiation therapy in your chest area
- smoking or using other tobacco products
Also, while having a family history of breast cancer generally increases your personal risk of breast cancer development, HER2-positive breast cancer is not hereditary.
What About Breast Cancer In Men
The stages of breast cancer relate to how much the cancer has grown and how far its spread. Generally, the earlier breast cancer is diagnosed and treated, the higher the chances for long-term survival.
|Stage 0||This is a precancerous stage with no invasive cancer cells.|
|Stage 1||The tumor is small and localized to the breast. There may be a small amount of cancer in nearby lymph nodes.|
|Stage 2||The tumor is still localized to the breast but is larger and may have spread to several nearby lymph nodes.|
|Stage 3||This stage includes cancers that have spread to the skin, chest wall, or multiple lymph nodes in or near the breast.|
|Stage 4||This is metastatic breast cancer, meaning its spread to one or more distant parts of the body, most commonly to the bones, lungs, or liver.|
The stages of breast cancer are based on the following factors:
- tumor size
- whether the lymph nodes contain cancer cells
- whether the cancer has metastasized, meaning its spread to other, more distant parts of the body
Since 2018, the following factors have also been used to determine breast cancer stage:
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Histological Grade And Ki67
Histological grade information was available from the ICD-O-3 code and categorized as low , intermediate and high according to the Elston-Ellis modification of the Scarff-Bloom-Richardson grading system . Women with anaplastic carcinoma were excluded, leaving n=24,137 women for the analysis . Ki67 has been recorded routinely since 2011 and was categorized as low , intermediate or high according to cutoffs in the Norwegian treatment guidelines .
What Is Her2 Breast Cancer
HER2 stands for human epidermal growth factor receptor 2. This gene is responsible for helping cells grow, divide, and repair themselves. However, in about 10% to 20% of breast cancers, the HER2 gene “breaks” and starts making extra copies of itself.
These copies order breast cells to make too many HER2 receptors or increase their activity, which in turn causes cancer cells to multiply.
HER2 breast cancer is cancer that has a HER2 gene defect. These defects may develop at any point in a person’s life. As of today, researchers don’t know what causes the gene to start acting abnormally.
While HER2 breast cancer is more aggressive than other cancers and has a higher tendency to metastasize to the brain, targeted treatments demonstrate excellent results. This is why if you’ve been diagnosed with breast cancer, it’s imperative to test for the HER2 gene abnormality.
When cancer recurs or spreads, it needs to be retested for the HER2 gene deformity. Research has shown that HER2 positive cancers can turn into HER2 negative cancers over time.
HER2 positive vs. HER2 negative
Since up to 20% of breast cancers test positive for HER2 gene deformity, it’s important to identify whether a patient has this abnormality as early as possible.
When the tests find the broken HER2 gene in breast cancer cells, the cancer is defined as HER2 positive. In cases where cancer doesn’t have abnormal HER2 proteins, it is HER2 negative.
The HER2 status of breast cancer affects the course of treatment.
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What Are The Survival Rates For Her2 Breast Cancer
Since HER2 breast cancer responds well to targeted treatment, the survival rate is fairly high. The four-year survival rate varies from 82.7% to 90.3%³.
The risk of recurrence for HER2 breast cancer in the years five to ten is low. According to a study, patients without lymph node involvement had a recurrence rate of 3.23%. For patients with lymph node involvement, the rate was 6.39%.
Human Epidermal Growth Factor Receptor 2 Status And Survival
Sixty-one percent of cases were HER2 positive. In univariate log-rank testing, HER2-positive patients were significantly more likely to relapse on tamoxifen, giving 5-year breast cancer-specific survival rates of 68% compared with 96% for the HER2-negative group . This significance was retained in Cox regression analysis when analysed alongside grade, size, ER status, age and chemotherapy treatment . The overall hazard ratio for HER2 positivity was 5.65 . This reduction in survival in HER2-positive cases persisted when patients were split into subgroups by ER status, tumour size and age .
KaplanMeier curves for HER2 status. Survival curves showing cumulative survival differences between patients positive or negative for HER2. P-value represents log-rank testing of the difference in cumulative survival.
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Her2 Positive Breast Cancer Recurrence
HER2 positive breast cancer is an aggressive disease with an elevated risk of metastatic spread if appropriate treatment or therapy is not administered. While HER2 positive breast cancer recurrence affects some patients, recent advancements in targeted therapies and long-term treatment approaches have made relapse less likely than ever before. The majority of patients with HER2 positive cancer do not experience recurrence.
Despite these odds, you may still feel nervous about your chances of cancer recurrence if you have a history of HER2 positive breast cancer. This is completely understandable. The best way to calm your fears and reduce your risk is to be proactive about your breast health, complete all recommended treatments or therapies, and maintain regular follow-up with your breast cancer clinical care team.