REVIEW ARTICLE
Year : 2011  |  Volume : 10  |  Issue : 1  |  Page : 28

Mechanisms of Trastuzumab resistance in ErbB2-driven breast cancer and newer opportunities to overcome therapy resistance


1 Eppley Institute for Research in Cancer and Allied Diseases, College of Medicine, University of Nebraska Medical Center, 985950 Nebraska Medical Center Omaha, NE, USA
2 Eppley Institute for Research in Cancer and Allied Diseases; Department of Genetics, Cell Biology and Anatomy, College of Medicine, University of Nebraska Medical Center, 985950 Nebraska Medical Center Omaha, NE, USA
3 Eppley Institute for Research in Cancer and Allied Diseases; Department of Genetics, Cell Biology and Anatomy, College of Medicine; UNMC-Eppley Cancer Center, University of Nebraska Medical Center, 985950 Nebraska Medical Center Omaha, NE, USA
4 Eppley Institute for Research in Cancer and Allied Diseases, College of Medicine; UNMC-Eppley Cancer Center, University of Nebraska Medical Center, 985950 Nebraska Medical Center Omaha, NE, USA
5 Eppley Institute for Research in Cancer and Allied Diseases, College of Medicine; Department of Genetics, Cell Biology and Anatomy, College of Medicine; Department of Biochemistry and Molecular Biology, College of Medicine; Department of Pathology and Microbiology, College of Medicine; Department of Pharmacology and Experimental Neuroscience, College of Medicine; UNMC-Eppley Cancer Center, University of Nebraska Medical Center, 985950 Nebraska Medical Center Omaha, NE, USA

Correspondence Address:
Srikumar M Raja
Eppley Institute for Research in Cancer and Allied Diseases, College of Medicine; UNMC-Eppley Cancer Center, University of Nebraska Medical Center, 985950 Nebraska Medical Center Omaha, NE
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1477-3163.90442

The Human Epidermal Growth Factor Receptor 2 (Her2, ErbB2 or Neu) is overexpressed in about 20 - 25% of breast cancers and is causally linked to oncogenesis, providing opportunities for targeted therapy. Trastuzumab (Herceptin™, Genentech Inc, San Francisco, CA), a humanized monoclonal antibody against ErbB2, is a successful example of this concept and has vastly improved the response to treatment and overall survival in a majority of ErbB2+ breast cancer patients. However, lack of response in some patients as well as relapse during the course of therapy in others, continue to challenge researchers and clinicians alike towards a better understanding of the fundamental mechanisms of Trastuzumab action and resistance to treatment. The exact in vivo mechanism of action of Trastuzumab remains enigmatic, given its direct effects on the ErbB2 signaling pathway as well as indirect contributions from the immune system, by virtue of the ability of Trastuzumab to elicit Antibody-Dependent Cellular Cytotoxicity. Consequently, multiple mechanisms of resistance have been proposed. We present here a comprehensive review of our current understanding of the mechanisms, both of Trastuzumab action and clinical resistance to Trastuzumab-based therapies. We also review newer strategies (based on ErbB2 receptor biology) that are being explored to overcome resistance to Trastuzumab therapy.


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