Evolution of anti-HER2 therapy in advanced HER2+ breast cancer or “why is trastuzumab still a key player?”. A review

The use of anti-HER2 therapy has dramatically changed the prognosis of patients with HER2+ breast cancer both in the early and advanced stages. New options that demonstrate the effectiveness of treatment of patients with HER2+ breast cancer can significantly increase the median progression-free survival and the overall frequency of objective response, the duration of this response. Some of them are still approved only in the first-line treatment of the metastatic form, either neo- or adjuvant regimens (for example, pertuzumab). At the same time, the antitumor conjugates being created, such as T-DM1 or T-DxD, have a common link in their structure – the monoclonal base antibody trastuzumab. Despite all the success of this class of drugs, progression occurs at a certain stage in these patients, and it is trastuzumab in combination with various chemotherapeutic regimens and/or drugs of other classes that remains the standard of late-line therapy and ensures the prolongation of patients' lives.