Royal College of Surgeons in Ireland
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Review of the status of neoadjuvant therapy in HER2-positive breast cancer

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journal contribution
posted on 2023-03-21, 17:45 authored by Gavin P Dowling, Stephen KeelanStephen Keelan, Sinead ToomeySinead Toomey, Gordon DalyGordon Daly, Bryan HennessyBryan Hennessy, Arnold HillArnold Hill

Purpose: The development of human epidermal growth factor receptor 2 (HER2)-directed therapies has revolutionized the treatment of HER2-positive breast cancer. The aim of this article is to review the continually evolving treatment strategies in the neoadjuvant setting of HER2-positive breast cancer, as well as the current challenges and future perspectives.

Methods: Searches were undertaken on PubMed and for relevant publications and trials.

Findings: The current standard of care in high-risk HER2-positive breast cancer is to combine chemotherapy with dual anti-HER2 therapy, for a synergistic anti-tumor effect. We discuss the pivotal trials which led to the adoption of this approach, as well as the benefit of these neoadjuvant strategies for guiding appropriate adjuvant therapy. De-escalation strategies are currently being investigated to avoid over treatment, and aim to safely reduce chemotherapy, while optimizing HER2-targeted therapies. The development and validation of a reliable biomarker is essential to enable these de-escalation strategies and personalization of treatment. In addition, promising novel therapies are currently being explored to further improve outcomes in HER2-positive breast cancer.



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Published Citation

Dowling GP. et al. Review of the status of neoadjuvant therapy in HER2-positive breast cancer. Front Oncol. 2023;13:1066007.

Publication Date

30 January 2023

PubMed ID



  • Beaumont Hospital
  • Molecular Medicine
  • Surgery


Frontiers Research Foundation


  • Published Version (Version of Record)