Comprehensive Guide to Breast Cancer Targeted Drugs｜How to Choose? Who Should Use Them? Understand in One Article
Breast cancer is not just one type. Just like colds can be viral or bacterial, breast cancer also has different types. Different types of breast cancer require different treatment methods.
"Targeted therapy" has become a very important breast cancer treatment in recent years. By using genetic testing to identify the "weaknesses" of cancer cells, precise drugs are used to attack them, significantly improving effectiveness and reducing side effects.
This article will help you categorize and explain the common types of breast cancer targeted therapies and their corresponding drugs, as well as clarify when to use these drugs, how to use them, and how to choose the appropriate ones.
🔹 1. BRCA Mutated Breast Cancer (Common in Familial Breast Cancer)
🔍 What is BRCA?
BRCA is a gene in the body that helps repair DNA. If this gene mutates, cancer cells are like "unable to repair themselves," making it easy for them to grow uncontrollably, leading to breast cancer or ovarian cancer.
🧪 Available medications:
Talazoparib (Talzenna) Oral medication, suitable for patients with BRCA mutations, HER2-negative, and advanced breast cancer.
Olaparib (Lynparza) ：Oral medication, used by similar groups as mentioned above, but can also serve as an adjuvant therapy after surgery.
✅ How to choose?
The effects of the two drugs are similar, but Olaparib (Lynparza)It is supported by more clinical studies and can be used in more treatment stages, making it a more common choice.
🔹 2. Hormone Receptor-Positive Breast Cancer (ER+/HER2-)
🔍 What is ER / PR?
This type of breast cancer cells have receptors for estrogen (ER) or progesterone (PR), and they grow in response to hormonal stimulation in the body. This is the most common type of breast cancer, accounting for about 70% of patients.
🧪 Available medications:
In addition to hormone drugs, doctors often add so-called "CDK4/6 inhibitors" for these patients, which pause cancer cell division and extend the duration of disease stability.
Palbociclib (Ibrance) : Oral medication. It is the first drug to be marketed, with the most usage and the most stability.
Ribociclib (Kisqali) ：Oral medication. It is currently the only drug proven to extend overall survival and is highly recommended in international guidelines.
Abemaciclib (Verzenio) ：Oral medication. The feature is taking the medicine daily without interruption, suitable for patients who do not want to stop the medication periodically.
🔹 3. HER2 Overexpressing Breast Cancer (HER2+)
🔍 What is HER2?
HER2 is a protein that, when overexpressed on breast cancer cells, causes the cancer cells to grow uncontrollably, like stepping on the gas pedal. HER2(+) breast cancer was once considered very aggressive, but now there are many effective targeted therapies, and treatment outcomes have improved significantly.
🧪 Available medications:
Trastuzumab (Herceptin) ：Intravenous injection. It is a representative HER2 targeted drug, used by almost all HER2(+) patients.
Pertuzumab (Perjeta) ：Intravenous injection. Often used in combination with trastuzumab to provide "dual blockade," enhancing therapeutic efficacy.
Trastuzumab Emtansine Lipid Microspheres (Kadcyla):Injection. It is an antibody-drug conjugate that combines targeted drugs and chemotherapy drugs, used for patients who have previously been treated with trastuzumab but have insufficient therapeutic effects.
Lapatinib (Tykerb) : Oral medication, more suitable for patients who cannot receive injections or have a risk of brain metastasis.
🔹 4. mTOR Inhibitors (Help Prolong the Effect of Hormonal Drugs)
🔍 What is mTOR?
mTOR is a signaling switch that controls cell growth. When hormone therapy starts to become less effective, this type of drug can "hold it back," helping to maintain the effectiveness of the original treatment.
🧪 Available medications:
Everolimus (Afinitor): Oral medication. Usually used in combination with hormone therapy, suitable for HER2-negative, hormone receptor-positive breast cancer, especially used when the disease recurs or progresses.
🔹 5. VEGF Inhibitors (Starving the Tumor)
🔍 Why block the blood vessels?
For tumors to grow, they must have blood vessels to supply nutrients and oxygen. The function of VEGF inhibitors is to prevent tumors from creating new blood vessels, starving the cancer cells.
🧪 Available medications:
Bevacizumab (Avastin) ：Intravenous injection. Often used together with chemotherapy for the control of metastatic breast cancer.
🧠 Why undergo typing and genetic testing?
Every breast cancer patient's tumor is different. Some grow based on hormones, some have excess HER2, some are hereditary, and some have no clear targets. Accurate testing can help doctors choose the most suitable and effective treatment for you.
- HER2 Positive → Suitable for use with HER2 targeted drugs
- BRCA Mutation → PARP inhibitor works well
- ER / PR Positive → Mainly hormone + CDK4/6 inhibitors
- No target expression → May consider immunotherapy or chemotherapy
👉 It is recommended to discuss with your attending physician whether tests for HER2, BRCA, hormone receptors, etc. are necessary.
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