skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8852

HER2-positive male breast cancer: an update

Review

(2469) Views  (767) Full article downloads

Authors: Laura Ottini, Carlo Capalbo, Piera Rizzolo, et al

Published Date October 2010 Volume 2010:2 Pages 45 - 58
DOI: http://dx.doi.org/10.2147/BCTT.S6519

Laura Ottini1, Carlo Capalbo2, Piera Rizzolo1, Valentina Silvestri1, Giuseppe Bronte3, Sergio Rizzo3, Antonio Russo3
1Department of Experimental Medicine, “Sapienza” University of Rome, Rome, Italy; 2Medical Oncology, IDI-IRCCS, Rome, Italy; 3Department of Surgical and Oncological Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy

Abstract: Although rare, male breast cancer (MBC) remains a substantial cause for morbidity and mortality in men. Based on age frequency distribution, age-specific incidence rate pattern, and prognostic factor profiles, MBC is considered similar to postmenopausal breast cancer (BC). Compared with female BC (FBC), MBC cases are more often hormonal receptor (estrogen receptor/progesterone receptor [ER/PR]) positive and human epidermal growth factor receptor 2 (HER2) negative. Treatment of MBC patients follows the same indications as female postmenopausal with surgery, systemic therapy, and radiotherapy. To date, ER/PR and HER2 status provides baseline predictive information used in selecting optimal adjuvant/neoadjuvant therapy and in the selection of therapy for recurrent or metastatic disease. HER2 represents a very interesting molecular target and a number of compounds (trastuzumab [Herceptin®; F. Hoffmann-La Roche, Basel, Switzerland] and lapatinib [Tykerb®, GlaxoSmithKline, London, UK]) are currently under clinical evaluation. Particularly, trastuzumab, a monoclonal antibody which selectively binds the extracellular domain of HER2, has become an important therapeutic agent for women with HER2-positive (HER2+) BC. Currently, data regarding the use of trastuzumab in MBC patients is limited and only few case reports exist. In all cases, MBC patients received trastuzumab concomitantly with other drugs and no severe toxicity above grade 3 was observed. However, MBC patients that would be candidate for trastuzumab therapy (ie, HER2+/ER+ or HER2+/ER- MBCs) represent only a very small percentage of MBC cases. This is noteworthy, when taking into account that trastuzumab is an important and expensive component of systemic BC therapy. Since there is no data supporting the fact that response to therapy is different for men or women, we concluded that systemic therapy in MBC should be considered on the same basis as for FBC. Particularly in male patients, trastuzumab should be considered exclusively for advanced disease or high-risk HER2+ early BCs. On the other hand, lapatinib (Tykerb), a novel oral dual tyrosine kinase inhibitor that targets both HER2 and epidermal growth factor receptor, may represent an interesting and promising therapeutic agent for trastuzumab-resistant MBC patients.

Keywords: target therapy, trastuzumab, lapatinib




 

Other articles by Professor Laura Ottini



Readers of this article also read:

New approaches in the management of advanced breast cancer – role of combination treatment with liposomal doxorubicin
Challenges in the development of future treatments for breast cancer stem cells
Progress in the development of a therapeutic vaccine for breast cancer
Lapatinib: new opportunities for management of breast cancer
Role of trastuzumab in the management of HER2-positive metastatic breast cancer
Bones, breasts, and bisphosphonates: rationale for the use of zoledronic acid in advanced and early breast cancer
Emerging role of brain metastases in the prognosis of breast cancer patients
Antiemetic therapy options for chemotherapy-induced nausea and vomiting in breast cancer patients
Potential clinical applications of halichondrins in breast cancer and other neoplasms
Role of lapatinib alone or in combination in the treatment of HER2-positive breast cancer
  • Testimonials

    "... I was impressed at the rapidity of publication from submission to final acceptance." Dr Edwin Thrower, PhD, Yale University