Treating HER2-Positive Breast Cancer
- Youwanush Kongdan
- Jan 14, 2025
- 3 min read
Updated: May 24
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.
Nam Rak 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 Nam Rak 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:
Nam Rak 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 Nam Rak 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.
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Disclaimer: This information is for general education only and is not a substitute for personalised medical advice. Please consult a qualified specialist.
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