Triple positive breast cancer: A distinct subtype?

Alessandra Cassano, Patrizia Vici, Laura Pizzuti, Clara Natoli, Teresa Gamucci, Luigi Di Lauro, Maddalena Barba, Domenico Sergi, Claudio Botti, Andrea Michelotti, Luca Moscetti, Luciano Mariani, Fiorentino Izzo, Loretta D'Onofrio, Isabella Sperduti, Francesca Conti, Valentina Rossi, Marcello Maugeri-Saccà, Marcella Mottolese, Paolo Marchetti

Risultato della ricerca: Contributo in rivistaArticolo in rivista

61 Citazioni (Scopus)

Abstract

Breast cancer is a heterogeneous disease, and within the HER-2 positive subtype this is highly exemplified by the presence of substantial phenotypical and clinical heterogeneity, mostly related to hormonal receptor (HR) expression. It is well known how HER-2 positivity is commonly associated with a more aggressive tumor phenotype and decreased overall survival and, moreover, with a reduced benefit from endocrine treatment. Preclinical studies corroborate the role played by functional crosstalks between HER-2 and estrogen receptor (ER) signaling in endocrine resistance and, more recently, the activation of ER signaling is emerging as a possible mechanism of resistance to HER-2 blocking agents. Indeed, HER-2 positive breast cancer heterogeneity has been suggested to underlie the variability of response not only to endocrine treatments, but also to HER-2 blocking agents. Among HER-2 positive tumors, HR status probably defines two distinct subtypes, with dissimilar clinical behavior and different sensitivity to anticancer agents. The triple positive subtype, namely, ER/PgR/Her-2 positive tumors, could be considered the subset which most closely resembles the HER-2 negative/HR positive tumors, with substantial differences in biology and clinical outcome. We argue on whether in this subgroup the "standard" treatment may be considered, in selected cases, i.e., small tumors, low tumor burden, high expression of both hormonal receptors, an overtreatment. This article review the existing literature on biologic and clinical data concerning the HER-2/ER/PgR positive tumors, in an attempt to better define the HER-2 subtypes and to optimize the use of HER-2 targeted agents, chemotherapy and endocrine treatments in the various subsets.
Lingua originaleEnglish
pagine (da-a)69-76
Numero di pagine8
RivistaCancer Treatment Reviews
Volume41
DOI
Stato di pubblicazionePubblicato - 2015

Keywords

  • Anti-HER-2 agents
  • Antineoplastic Agents, Hormonal
  • Biomarkers, Tumor
  • Breast Neoplasms
  • Breast cancer
  • Chemotherapy
  • Drug Resistance, Neoplasm
  • Female
  • Hormonal therapy
  • Humans
  • Molecular Targeted Therapy
  • Phenotype
  • Prognosis
  • Receptor, ErbB-2
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Signal Transduction
  • Treatment Outcome
  • Triple positive

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