Abstract
The development of new HER2-directed therapies has resulted in a significant prolongation of survival for women with metastatic HER2-positive breast cancer. Discoveries in the laboratory inform clinical trials which are the basis for improving the standard of care and are also the backbone for quality improvement. Clinical trials can be completed more rapidly by expanding trial enrollment to community sites. In this article we review some of the challenges in treating metastatic breast cancer with HER2-directed therapies and our strategies for incorporating our community partners into the research network.
Highlights
Breast cancers arise from a single organ, the biology and natural history of the disease can be extremely variable
Until uniform genomic profiling becomes feasible, clinical decision making is based on tumor histology, stage, hormone receptor status, and HER2 status
This paper focuses on the use of HER2-targeted therapies in metastatic breast cancer and the importance of clinical trials and community practice collaboration in understanding the biology of this disease and advancing therapy
Summary
Breast cancers arise from a single organ, the biology and natural history of the disease can be extremely variable. Gene expression profiling allows us to subcategorize breast cancer into four “intrinsic subtypes”, each with a unique natural history and response to therapy—Luminal A, Luminal B, Basal-like, and HER2 (human epidermal growth factor receptor 2) “enriched” [1,2]. Until uniform genomic profiling becomes feasible, clinical decision making is based on tumor histology, stage, hormone receptor status, and HER2 status. This paper focuses on the use of HER2-targeted therapies in metastatic breast cancer and the importance of clinical trials and community practice collaboration in understanding the biology of this disease and advancing therapy
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