Systemic therapy for hormone receptor-positive/human epidermal growth factor receptor 2-negative early stage and metastatic breast cancer

Laura A. Huppert, Ozge Gumusay, Dame Idossa, Hope S. Rugo

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations

Abstract

Hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer is defined by the presence of the estrogen receptor and/or the progesterone receptor and the absence of HER2 gene amplification. HR-positive/HER2-negative breast cancer accounts for 65%–70% of all breast cancers, and incidence increases with increasing age. Treatment varies by stage, and endocrine therapy is the mainstay of treatment in both early stage and late-stage disease. Combinations with cyclin-dependent kinase 4/6 inhibitors have reduced distant recurrence in the early stage setting and improved overall survival in the metastatic setting. Chemotherapy is used based on stage and tumor biology in the early stage setting and after endocrine resistance for advanced disease. New therapies, including novel endocrine agents and antibody-drug conjugates, are now changing the treatment landscape. With the availability of new treatment options, it is important to define the optimal sequence of treatment to maximize clinical benefit while minimizing toxicity. In this review, the authors first discuss the pathologic and molecular features of HR-positive/HER2-negative breast cancer and mechanisms of endocrine resistance. Then, they discuss current and emerging therapies for both early stage and metastatic HR-positive/HER2-negative breast cancer, including treatment algorithms based on current data.

Original languageEnglish (US)
Pages (from-to)480-515
Number of pages36
JournalCA Cancer Journal for Clinicians
Volume73
Issue number5
DOIs
StatePublished - Sep 1 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.

Keywords

  • breast neoplasms
  • clinical trials
  • hormone receptor-positive
  • hormone therapy
  • human epidermal growth factor receptor 2 (HER2)-negative breast cancer

PubMed: MeSH publication types

  • Journal Article
  • Review

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