Middle East Journal of Cancer

Management of HER2-Low Metastatic Breast Cancer: A Comprehensive Statement by an Expert Group from the Middle East and Africa Region

Document Type : Review Article(s)

Authors

Shaheenah Dawood 1
Mohsen Mokhtar 2
Ahmed Alwbari 3
Bernardo Leon Rapoport 4, 5
Ece Esin 6
Hassan Jaafar 7
Jamal Zekri 8, 9
Narjiss Berrada 10
Ozgur Ozyilkan 11
Nagi S. El Saghir 12

1 Department of Oncology, Mediclinic Hospital, Dubai, United Arab Emirates

2 Department of Oncology, Cairo University, Cairo, Egypt

3 Department of Oncology, Almoosa Specialist Hospital, Oncology Center, Al Mubarraz, Saudi Arabia

4 The Medical Oncology Centre of Rosebank, Johannesburg, South Africa

5 Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa

6 Department of Medical Oncology, Bayindir Hospital, Ankara, Turkey

7 Department of Oncology, Sheikh Khalifa Specialty Hospital, Abu Dhabi, United Arab Emirates

8 Department of Oncology, Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, United Kingdom

9 College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia

10 Department of Oncology, Chellah University, Rabat, Morocco

11 Department of Oncology, Baskent University, Ankara, Turkey

12 Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

https://doi.org/10.30476/mejc.2024.103586.2143
Abstract
Approximately 50 to 67% of breast cancers (BCs), traditionally categorized as human epidermal growth factor receptor 2 (HER2)-negative, but demonstrating low HER2 expression, are now being defined as a new HER2-low subset or HER2-low category of BC. For metastatic BC (mBC), standard therapy options include targeted approaches, such as cyclin-dependent kinase 4/6 inhibitors, phosphoinositide 3-kinase inhibitors, poly (adenosine diphosphate-ribose) polymerase inhibitors, and anti-programmed death-ligand 1 agents, depending on tumor type and its molecular profile. Recent clinical trials reported significant clinical benefits from novel anti‑HER2 antibody‑drug conjugates, such as trastuzumab deruxtecan in HER2‑low mBC. Novel treatment options have increased the complexity of the clinical decision‑making process, particularly for treatment sequencing for each clinical setting. A regional expert committee meeting was held to discuss the challenges, overcome limitations, and present recommendations to enhance HER2 reporting as well as treatment of patients with HER2‑low mBC in the Middle East and Africa region.

Highlights

Shaheenah Dawood (PubMed)

Nagi S. El-Saghir (Google Scholar)

Keywords

Breast Neoplasms
HER2-low
Immunoconjugates
Trastuzumab deruxtecan
Sacituzumab govitecan
Subjects

How to cite this article:

Dawood S, Mokhtar M, Alwbari A, Rapoport BL, Esin E, Jaafar H, Zekri J, Berrada N, Ozyilkan O, El Saghir NS. Management of HER2-Low Metastatic Breast Cancer: A Comprehensive Statement by an Expert Group from the Middle East and Africa Region. Middle East J Cancer. 2025;16(3): 299-321. doi: 10.30476/mejc.2024.103586.2143.

 

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Middle East Journal of Cancer
Volume 16, Issue 4
Autumn 2025
Pages 299-321

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