Review article optimizing the use of her-2/neu targeting agents in breast cancer : a developing nation perspective.

BACKGROUND Her-2/nue positive breast cancer is an aggressive disease with a higher potential of invasion and metastasis. It constitutes around 20% of all the breast cancer cases and even a higher incidence has been reported in Egypt. Agents targeting Her-2 have been shown to be associated with improvement in response rate, disease free and overall survival. DIAGNOSIS Different biomarkers have recently emerged to predict the benefit of trastuzumab and/or lapatinib. Phosphatase and tensin homolog (PTEN), topoisomerase 2 alpha (TOPO2A) AND p95HER2 have been associated with appealing results in selecting patients who may or may not respond to these grants. RESULTS AND CONCLUSION Despite the impressive results of Her-2/nue targeting agents in both the adjuvant and metastatic phases, still a significant fraction of patients are not offered these agents particularly those in countries with limited resources due to their high cost. In this review, we will discuss how we can optimally use these agents from developing nation perspective. We will elaborate on different schedules available and will highlight the importance of incorporating different biomarkers to assist in proper selection of patients who can optimally benefit these agents.