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HER-2-Positive Metastatic Breast Cancer: Optimizing Trastuzumab-Based Therapy

Department of Gynecology and Obstetrics, Klinikum Offenbach, Offenbach, Germany

Key Words. Trastuzumab • Metastatic breast cancer • Combination therapy • Treatment beyond disease progression

Correspondence: Christian Jackisch, M.D., Klinikum Offenbach GmbH, Department of Gynecology and Obstetrics, Starkenburgring 66, D-63069 Offenbach, Germany. Telephone: 49-0-69-8405-3850; Fax: 49-0-69-8405-4456; e-mail: christian.jackisch{at}klinikum-offenbach.de

Trastuzumab with a taxane as first-line therapy is now the standard of care for patients with human epidermal growth factor receptor 2 (HER-2)-positive metastatic breast cancer (MBC). The search for additional and more effective trastuzumab-based therapies continues. Novel combinations of trastuzumab with chemotherapeutic agents, including vinorelbine, gemcitabine, and capecitabine, and hormonal therapy agents, such as tamoxifen and aromatase inhibitors, are currently under investigation in clinical trials. Available data suggest these combinations will provide additional treatment options that may ultimately lead to better outcomes for patients with HER-2-positive MBC. Evidence is growing for the use of trastuzumab treatment beyond disease progression and retreatment after (neo)adjuvant relapse is being explored to assist in clinical decision making. Already, the use of trastuzumab in the metastatic setting has changed HER-2-positive status from a marker of poor prognosis to one of better overall outcome, and ongoing studies should expand further the treatment options for patients with HER-2-positive MBC.

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