New treatment brightens HER2-positive cancer’s once dismal outlook

Tumors hold many critical details that will determine the course of a breast cancer patient’s journey — and the effectiveness of the treatment that she or he receives.

A biopsied tumor will tell physicians how aggressive the cancer is and which treatments will lead to the most positive outcome. One detail a patient may hear upon diagnosis is whether a cancer is HER2-positive or HER2-negative. While HER2-positive is the less desired outcome, newer treatments are brightening the outlook for those diagnosed with it.

HER2 is a protein that promotes the growth of cancer cells. Breast cancer cells with higher-than-normal levels of HER2 are called HER2-positive breast cancer. These cancers tend to grow and spread faster than other breast cancers, but are more likely to respond to treatment with drugs targeted to that protein, according to the American Cancer Society.

“HER2-positive breast cancer means those cancer cells contain this protein and typically have it in abundance,” said Dr. Selyne Samuel, a surgical oncologist with Premier Surgical Oncology. “The breast cancer is more aggressive, can grow rapidly, and, unfortunately, can spread to other places quickly.”

Thankfully, newer treatments can target the HER2 protein to slow its spread or cause the tumor to shrink. In some instances, it also provides longer survival for patients with metastatic HER2-positive disease, said Samuel, who practices with Premier Physician Network.

Breast tumors found to be an aggressive form of cancer are always tested to give oncologists a true picture of their biology. This helps guide the treatment of the disease outside of surgery by indicating if it contains the HER2 protein. Patients who are HER2-positive require additional treatment beyond the standard of care, which typically includes hormone-block medications, Dr. Samuel said.

“We know HER2-positive patients will likely need chemotherapy before surgery,” Dr. Samuel said. “And depending on their response to the chemotherapy, they may or may not need additional drugs after they’re done with their surgery.”

The introduction of new treatments has increased the overall survival rate of HER2-positive breast cancer and, in some cases, have made it curable. T-DM1, a drug approved by the Food and Drug Administration more than six years ago, previously was used to treat metastatic HER2-positive breast cancer, but now is being used to treat early stage HER2-positive breast cancer in cases in which a patient has undergone chemotherapy, had surgery, but still had cancer cells found in the breast specimen that was removed.

Meanwhile, a new trial drug called ENHER2 can be used to treat incurable and/ or metastatic breast cancer and has been shown to have less toxic side effects compared to T-DM1. ENHER2 can be used on patients who have failed initial treatments.

“That’s what’s great about research,” Dr. Samuel said. “We’re able to develop drugs and treatment options for patients who 20 years ago would have had a dismal prognosis, but who today are living up to 10 years longer with stage four disease.”

Still, aggressive cancer like that fueled by the HER2-protein cannot be successfully treated if it’s not caught in the first place. The earlier a person’s cancer is caught, the better the outcome. Early screening through regular mammograms is critical, especially for younger women.

“Unfortunately, the younger a woman, the more aggressive her breast cancer usually,” Dr. Samuel said. “A woman shouldn’t wait until October to think about screening. She should always talk to her doctor if she’s unsure of the right time to start screening and not delay.”

For more information about HER2-positive breast cancer, or to schedule an appointment with a Premier Physician Network provider near you, visit PremierHealth.com/MakeAnAppointment.