Breast Cancer: Targeted and Immunotherapies
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This section covers the following topics:
What is ?
is a type of cancer treatment designed to attack or kill cancer cells, while sparing normal cells as much as possible. They are designed to target abnormal proteins, receptors or genes that are found in cancer cells or the surrounding tissue.
PARP inhibitors
PARP inhibitors are a type of that works by blocking a protein that the body uses to repair damage. They were initially developed to treat cancers in people with an inherited or mutation.
- For breast cancer, two PARP inhibitors have received FDA-approval as for treating people with an inherited mutation:
- Lynparza ()
- ()
- For people with early breast cancer at high risk for recurrence:
- Lynparza may be used as treatment after chemotherapy in people with an inherited or mutation. Lynparza is approved for patients with high-risk, early breast cancer and an inherited or mutation.
Researchers are studying new ways to use PARP inhibitors to treat breast cancer, including:
- for people with an in a different gene that repairs damage (for example: , or ).
- for people who do not have an inherited gene mutation, but their tumor tested positive for an acquired mutation in a gene that repairs damage.
Visit our Featured Research section for more information.
Other targeted therapies
Targeted therapies are often given to people based on specific changes in their cancer cells. Tumor testing can help doctors identify the patients most likely to benefit from a . Common targeted therapies used in breast cancer include:
Triple-negative breast cancers
- , that has progressed may be treated with the drug Trodelvy (sacituzumab govitecan).
or HER2-low breast cancers
- breast cancers of all stages are often treated with drugs that target the protein. Common anti-HER2 therapies include Herceptin (trastuzumab), Perjeta (pertuzumab) and Tukysa (tucatinib), Phesgo (pertuzumab, trastuzumab and hyaluronidase) and Enhertu (T-DXd).
- or advanced HER2-low breast cancers may be treated with the anti-HER2 drug Enhertu.
Hormone receptor-positive breast cancers
- advanced breast cancers are often treated with CDK4/6 inhibitors. CDK4/6 inhibitors target proteins found in some breast cancers called CDK inhibitors. The three CDK4/6 inhibitors approved for use in breast cancer are: Ibrance (palbociclib), Kisqali (ribociclib) and Verzenio (abemaciclib).
- breast cancers that test positive for a tumor called PIK3CA may be treated with the drug Piqray (alpelisib). PIK3CA is an acquired gene mutation found in some ER-positive breast cancers.
- The drug Truqap (capivasertib) combined with fulvestrant is approved to treat , advanced or breast cancer with a mutation in , PIK3 or AKT1 genes which recurred or got worse after standard hormone therapy.
What is ?
Immunotherapies are cancer treatments that help the body’s immune system detect and attack cancer cells. Immune checkpoint inhibitors are a type of used to treat several types of cancer, including breast cancer. Some cancer cells can switch off the immune system. Immune checkpoint inhibitors are drugs that prevent this from happening. This allows the immune system to find, unmask and destroy cancer cells. Immune checkpoint inhibitors are approved for treating breast cancer in the following situations:
- Keytruda (pembrolizumab) is approved in combination with chemotherapy for treatment of that is or locally recurrent and unresectable that tests positive for a called .
- Keytruda is approved for the treatment of triple-negative breast cancer that is at high risk for recurrence. In this setting, Keytruda is used along with chemotherapy as therapy before surgery. Following surgery, Keytruda is continued alone.
Name of Drug |
Cancer Stage |
Indication |
Biomarker |
Type of Agent |
Herceptin |
Early stage |
The treatment of Her2-positive breast cancer |
HER2 overexpression (HER2-positive) |
Antibody targeting HER2 receptors |
Perjeta (pertuzumab) |
Locally advanced, inflammatory or early stage |
Combined with Herceptin (trastuzumab) and docetaxel as treatment before surgery (neoadjuvant) |
HER2 overexpression (HER2-positive) |
Antibody targeting HER2 receptors |
Phesgo (pertuzumab, trastuzumab combined injection) |
Early stage |
|
HER2 overexpression (HER2-positive) |
Antibody targeting HER2 receptors |
Keytruda (pembrolizumab) |
Early stage TNBC at high risk for recurrence |
Before surgery Keytruda is used along with chemotherapy as neoadjuvant therapy. Following surgery, Keytruda is continued alone. |
Triple-negative (ER/PR-negative, HER2-negative) |
Type of immunotherapy known as an immune checkpoint inhibitor |
Lynparza (olaparib) |
Early stage breast cancer at high risk for recurrence |
Given for one year as maintenance therapy after completion of neoadjuvant or neoadjuvant chemotherapy and local treatment (surgery and, or radiation) |
BRCA1 or BRCA2 inherited mutation (germline mutation) |
Type of targeted therapy known as a PARP inhibitor |
Kadcyla |
Early stage |
Adjuvant therapy for people with early breast cancer who still have disease after neoadjuvant taxane and treatment with Herceptin |
HER2 overexpression (HER2-positive) |
Antibody targeting HER2 receptors |
Name of Drug |
Cancer Stage |
Indication |
Biomarker |
Type of Agent |
Perjeta (pertuzumab) |
Locally advanced, inflammatory or early stage |
Combined with Herceptin (trastuzumab) and docetaxel as treatment before surgery (neoadjuvant) |
HER2 overexpression (HER2-positive) |
Antibody targeting HER2 receptors |
Enhertu (fam-trastuzumab-deruxtecan-nxki) |
Metastatic |
Treatment for people who have:
|
HER2 overexpression (HER2-positive) |
Antibody-drug conjugate (chemotherapy attached to antibody targeting HER2 receptor) |
Enhertu (fam-trastuzumab-deruxtecan-nxki) |
Metastatic |
Treatment for people with tumors that are HER2-low who:
|
HER2-low |
Antibody-drug conjugate (chemotherapy attached to antibody targeting HER2 receptor) |
Enhertu (fam-trastuzumab-deruxtecan-nxki) |
Metastatic |
Treatment of unresectable or metastatic HER2-positive solid tumors (including breast cancer) in people who have received prior systemic treatment and have no satisfactory alternative treatment options |
HER2-positive |
Antibody-drug conjugate (chemotherapy attached to antibody targeting HER2 receptor) |
Kadcyla |
Metastatic |
For treatment in people whose cancer got worse after receiving Herceptin and chemotherapy in the following settings:
|
HER2 overexpression (HER2-positive) |
Antibody targeting HER2 receptors |
Tukysa (tucatinib) |
Metastatic |
In combination with Herceptin (trastuzumab) to treat cancer which has progressed after at least one prior treatment with an anti-HER2 treatment in the metastatic setting |
HER2 overexpression (HER2-positive) |
Targeted therapy known as a kinase inhibitor that targets HER2 receptors |
Trodelvy (sacituzumab govitecan-hziy) |
Metastatic |
For metastatic breast cancer that progressed, recurred or did not respond to at least two previous lines of treatment |
Triple-negative (ER/PR-negative, HER2-negative) |
Antibody-drug conjugate (chemotherapy attached to antibody found in TNBC) |
Afinitor |
Metastatic |
Combined with Aromasin (exemestane) for postmenopausal women with advanced breast cancer which progressed with Femara (letrozole) or Arimidex (anastrozole) |
HR-positive and HER2-negative |
MTOR inhibitor (type of kinase inhibitor) |
Orserdu |
Metastatic |
Used alone to treat men or postmenopausal women with HR-positive, HER2-negative breast cancer, which progressed after at least one line of hormone therapy therapy |
HR-positive, HER2-negative with an ESR1 mutation |
Type of hormonal therapy known as SERD (selective estrogen receptor degrader or downregulator) |
Piqray |
Metastatic |
Combined with Faslodex (fulvestrant) as treatment in men or post-menopausal women who progressed on or after treatment with hormone therapy |
HR-positive, HER2-negative and positive for a PIK3CA tumor mutation |
Targeted therapy known as a kinase inhibitor that blocks the PIK3 pathway |
Truqap |
Metastatic |
Combined with fulvestrant as treatment for HR-positive, advanced or metastatic breast cancer which recurred or got worse after standard hormone therapy |
PTEN, PIK3 or AKT1 mutation in the tumor |
Targeted therapy known as a kinase inhibitor that blocks the AKT pathway |
Verzenio (abemaciclib) |
Metastatic |
Used alone to treat breast cancer that has progressed after treatment with hormone therapy and chemotherapy in the metastatic setting |
HR-positive and HER2-negative |
Targeted therapy known as a kinase inhibitor that blocks the CDK4/6 pathway |
Metastatic |
Combined with Faslodex (fulvestrant) as treatment in women whose disease progressed following endocrine therapy |
HR-positive and HER2-negative |
Targeted therapy known as a kinase inhibitor that blocks the CDK4/6 pathway |
|
Ibrance |
Metastatic |
Combined with an aromatase inhibitor as treatment of advanced cancer as initial hormone therapy in postmenopausal women or in men |
HR-positive and HER2-negative |
Targeted therapy known as a kinase inhibitor that blocks the CDK4/6 pathway |
Metastatic |
Combined with Faslodex (fulvestrant) as treatment in postmenopausal women or in men whose disease progressed following endocrine therapy |
HR-positive and HER2-negative |
Targeted therapy known as a kinase inhibitor that blocks the CDK4/6 pathway |
|
Kisqali |
Metastatic |
Combined with an aromatase inhibitor for the treatment of pre/perimenopausal or postmenopausal women as initial hormone based therapy |
HR-positive and HER2-negative |
Targeted therapy known as a kinase inhibitor that blocks the CDK4/6 pathway |
Metastatic |
Combined with Faslodex (fulvestrant) for the treatment of postmenopausal women, as initial hormone based therapy |
HR-positive and HER2-negative |
Targeted therapy known as a kinase inhibitor that blocks the CDK4/6 pathway |
|
Lynparza |
Metastatic |
For treatment of patients who have previously received chemotherapy, or hormone therapy for patients with hormone receptor HR-positive disease |
BRCA1 or BRCA2 mutation and HER2-negative |
Type of targeted therapy known as a PARP inhibitor |
Talzenna |
Metastatic |
For treatment of metastatic breast cancer |
BRCA1 or BRCA2 mutation and HER2-negative |
Type of targeted therapy known as a PARP inhibitor |
Keytruda |
Metastatic |
Combined with chemotherapy for treatment of locally recurrent unresectable or metastatic triple negative breast cancer |
Triple-negative (ER/PR-negative and HER2-negative) and PD-L1-positive |
Type of immunotherapy known as an immune checkpoint inhibitor |
Participate in Breast Cancer Treatment Research
Below are some of our featured research studies looking at new ways to treat breast cancer using targeted or immunotherapies. To search for additional studies, visit our Search and Enroll Tool.
Study of a New InvestigationaI Inhibitor to Treat People with Advanced Solid Tumors
Clinicaltrials.gov identifier:
NCT05932862
Clinicaltrials.gov identifier:
NCT04673448
Testing a Vaccine for Treating or Preventing Triple-Negative Breast Cancer
Clinicaltrials.gov identifier:
NCT04674306
Clinicaltrials.gov identifier:
NCT05720039
NUV-868 Alone and in Combination With PARP Inhibitors in Patients With Advanced Solid Tumors
Clinicaltrials.gov identifier:
NCT05252390
