Treating HER2-Positive Breast Cancer

Youwanush Kongdan
Jan 14, 2025
3 min read

Updated: 3 days ago

How is HER2-positive breast cancer treated?

HER2-positive breast cancer has too much HER2 protein, which makes cells grow quickly — but targeted drugs that bind HER2 (such as trastuzumab) have transformed the outlook, especially when combined with chemotherapy and other treatments.

Namarak Hospital is committed to providing care to HER 2- Positive breast cancer patients with international standards under the care of a team of expert doctors and modern technology to ensure that patients receive the most effective treatment.

What is HER2-Positive Breast Cancer?

HER 2- Positive breast cancer is a type of breast cancer that overexpresses the HER 2 protein, which stimulates cancer cells to grow and divide rapidly.

Targeted Therapy: Hope for HER 2- Positive Breast Cancer Patients

Targeted therapy is an innovative cancer treatment that directly kills cancer cells. It targets the HER 2 protein to inhibit cancer cell growth, significantly increasing patient survival.

What drugs are used for HER2-positive targeted therapy?

Monoclonal Antibodies

· Trastuzumab (Herceptin): The first drug approved in 1998, it works by binding to the HER 2 protein on the surface of cancer cells to stop their growth.

· Pertuzumab: Used in combination with Trastuzumab to enhance HER 2 inhibition. Often used together in early and metastatic disease.

Tyrosine Kinase Inhibitors (TKIs): Drugs that act inside cells to block the activity of HER 2, such as:
Lapatinib: Use in metastatic disease
Neratinib and Tucatinib: Can be used in both early and metastatic disease.
Antibody-Drug Conjugates (ADCs): Drugs that combine the precision of a targeted drug with a chemotherapy drug to deliver chemotherapy drugs directly to cancer cells, such as:
T-DM 1 ( Trastuzumab emtansine): Used in metastatic disease and in patients with surviving cancer cells after preoperative treatment.
T-DXd (Trastuzumab deruxtecan): A new and highly effective drug.

Treatment guidelines at Namarak Hospital (based on international standards):

1. Neoadjuvant Therapy: Used in patients with large tumors (≥ 2 cm) or with spread to lymph nodes, to help shrink the tumor and increase the chance of breast conserving surgery.

2. Adjuvant Therapy:

· De-escalation: For low-risk patients, such as small early-stage tumors, only Paclitaxel and Trastuzumab may be used to reduce side effects.

· Escalation therapy: For patients with high risk, such as large tumors or lymph node metastases , trastuzumab may be used in combination with pertuzumab.

3. Residual Disease Management: Patients who still have cancer cells remaining after preoperative treatment are treated with T-DM 1 to reduce the risk of recurrence.

Follow-up and holistic care:

Namarak Hospital emphasizes close follow-up to ensure patients have a good quality of life through radiological examinations, blood tests to monitor the recurrence of the disease ( ctDNA) in cases with indications, and physical and mental health rehabilitation.

Why choose Namarak Hospital?

Global Standards-Based Treatment: Uses NCCN and ASCO guidelines and incorporates the latest research findings such as APHINITY, KATHERINE , and PHERGain into treatment.
Cutting-edge technology: Molecular analysis and AI use are increasing the accuracy of diagnosis and treatment planning.
Specialist Medical Team: A multidisciplinary team with experience and expertise working closely together.

Frequently Asked Questions (FAQ)

What is HER2-positive breast cancer?

A cancer with excess HER2 receptors, found in about 1 in 5 breast cancers. It tends to grow faster but responds well to HER2-targeted therapy.

How is it treated?

With HER2-targeted drugs (e.g. trastuzumab) plus chemotherapy, and possibly surgery, radiation, or hormone therapy depending on the disease.

Do HER2-targeted drugs have side effects?

Generally well tolerated, but heart function is monitored during treatment.

Is HER2-positive cancer curable?

With today's targeted drugs the outlook is much better, especially when found early and treated fully.

What test confirms HER2-positive status?

IHC and/or FISH testing on the biopsy sample measures HER2, guiding targeted therapy.