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Breast Cancer: Targeted and Immunotherapies
Targeted therapies are designed to attack or kill cancer cells, while sparing normal cells. Immunotherapies help the immune system detect and attack cancer cells. Learn more about how they are used for breast cancer.

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Risk Management & Treatment > Cancer Treatment > By Cancer Type > Breast > Targeted and Immunotherapies

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Targeted and Immunotherapies for Breast Cancer

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:

  • breast cancers 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. 
  • People with advanced breast cancer 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).
  • The drug Piqray (alpelisib) is approved for people who have advanced, breast cancer who test positive for a tumor called PIK3CA. 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.

See our section for more information. 

Common targeted and immunotherapies used for breast cancer

Open Table
Targeted and immunotherapies for early-stage (stages 1, 2 or 3) breast cancer : Table listing the targeted and immunotherapies used for the treatment of early-stage breast cancer

Name of Drug

Cancer Stage

Indication

Biomarker

Type of Agent

Herceptin
(trastuzumab) 

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

  • Before surgery (neoadjuvant) treatment for tumors larger than 2 cm or node-positive, or 
  • After surgery (adjuvant) treatment for early breast cancer that has a high likelihood of coming back

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) 

PARP inhibitor

Kadcyla
(trastuzumab emtansine)

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

Open Table
Targeted and immunotherapies for advanced or metastatic breast cancer : Table listing the targeted and immunotherapies used for the treatment of advanced or metastatic breast cancer

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:

  • received a prior anti-HER2 therapy for metastatic breast cancer, or 
  • had their breast cancer come back during or within 6 months of completing treatment for their early-stage breast cancer

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:

  • received chemotherapy in the metastatic setting and whose cancer no longer responds to hormonal therapy
  • received chemotherapy in the adjuvant setting and whose cancer came back within 6 months of completing chemotherapy

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
(trastuzumab emtansine)

Metastatic 

For treatment in people whose cancer got worse after receiving Herceptin and chemotherapy in the following settings:

  • for metastatic disease, or
  • as adjuvant therapy, and experienced disease recurrence during or within 6 months of completing adjuvant therapy

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
(everolimus)

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
(elacestrant)

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
(alpelisib)

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 
(capivasertib)

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
(palbociclib)

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
(ribociclib)

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
(olaparib)

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
(talazoparib)

Metastatic 

For treatment of metastatic breast cancer

BRCA1 or BRCA2 mutation and HER2-negative

Type of targeted therapy known as a PARP inhibitor

Keytruda
(pembrolizumab)

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

Last updated July 07, 2024