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Breast cancer is cancer that forms in the cells of the breasts. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.

In addition to chemotherapy and hormone therapy, there are newer, more effective treatments that can attack specific breast cancer cells without harming normal cells. Currently, these targeted methods are commonly used in combination with standard chemotherapy drugs. However, targeted drugs often have less severe side effects than standard chemotherapy drugs.

How do breast cancer targeted therapies work?
Breast cancer targeted therapy uses drugs that block the growth of breast cancer cells in specific ways. For example, targeted therapy may block the action of an abnormal protein (such as HER2) that stimulates the growth of breast cancer cells.

For about 1 in 5 women with breast cancer, the cancer cells have too much of a growth-promoting protein known as HER2/neu (or just HER2) on their surface. These cancers, known as HER2-positive breast cancers, tend to grow and spread more aggressively. First line therapy is Injection Perjeta (Pertuzumab) and Injection Herceptin (Trastuzumab). While for second line therapy is Injection Kadcyla (Ado-Trastuzumab Emtansine).

A number of drugs have been developed that target this protein. The therapies are:

  • Pertuzumab (Perjeta): This monoclonal antibody can be given with trastuzumab and chemotherapy, either before surgery to treat early-stage breast cancer, or to treat advanced breast cancer. This drug is given intravenously (IV).

  • Trastuzumab (Herceptin): This is a monoclonal antibody, which is a man-made version of a very specific immune system protein. It is often given along with chemotherapy, but it might also be used alone (especially if chemo alone has already been tried).

Trastuzumab can be used to treat both early- and late-stage breast cancer. When started before or after surgery to treat early breast cancer, this drug is usually given for a total of 6 months to a year. For advanced breast cancer, treatment is often given for as long as the drug is helpful. This drug is given intravenously (IV). Common side effect of this therapy are body pain, weakness, and nausea.

  • Ado-trastuzumab emtansine (Kadcyla, also known as TDM-1): This is a monoclonal antibody attached to a chemotherapy drug. It is used by itself to treat advanced breast cancer in women who have already been treated with trastuzumab and chemotherapy. This drug is also given intravenously (IV).

There are some common side effects due to this chemotherapy.

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