Targeted and immunotherapy drugs for breast cancer

Your doctor might recommend you have a drug called abemaciclib. You might have it with:

• an aromatase inhibitor ( such as anastrozole, exemestane or letrozole)

• fulvestrant

This treatment is usually for people whose breast cancer has spread to ​lymph nodes​ in the armpit and has a high risk of coming back (recurrence). Your breast cancer must also be ​hormone receptor positive​ and ​HER2 negative​ .

Find out more abemaciclib (Verzenios) and its side effects

Alpelisib is a type of targeted drug. It’s for people who have ​locally advanced​ or secondary breast cancer and the cancer:

• is ​hormone receptor positive​

• is ​HER2 negative​

• has changes (mutation) in the gene known as PIK3CA

• has come back (recurred) after having a type of drug called a CDK4/6 inhibitor (for example abemaciclib, palbociclib, or ribociclib) with hormone therapy treatment

You may have alpelisib with a hormone therapy called fulvestrant. Your doctor will tell you more about this treatment and if it’s available to you.

Find out about having alpelisib and fulvestrant

Atezolizumab is a type of immunotherapy. You may have atezolizumab with a type of chemotherapy drug called nab-paclitaxel if you have ​triple negative breast cancer​ . 

It is for people with breast cancer that:

• cannot be removed by surgery

• has spread to surrounding tissue (locally advanced breast cancer)

• has spread to other parts of the body (secondary breast cancer)

Find out more about atezolizumab and nab-paclitaxel and its possible side effects

Capivasertib is a type of targeted treatment called a cancer growth blocker. You pronounce capivasertib as cap-ih-ver-sir-tib.

It is a treatment for some people with breast cancer that has spread to the surrounding tissue (locally advanced). Or if it has spread to other parts of the body (secondary breast cancer).

It is for people whose breast cancer is ​hormone receptor positive​ and ​HER2​ negative. 

The cancer must also have one or more of the following ​gene changes (mutations)​ :

• PIK3CA

• AKT1

• PTEN

To have capivasertib your cancer must have come back or not gone away after treatment with both of the following:

• an ​aromatase inhibitor​ such as anastrozole, exemestane or letrozole

• a type of cancer growth blocker called a cyclin dependant kinases (CDK) inhibitor. These are the drugs abemaciclib, palbociclib or ribociclib

You have capivasertib with a hormone treatment called fulvestrant.

Denosumab is a type of targeted drug called a ​monoclonal antibody​ .

When cancer spreads to the bones it can cause pain and weaken them. Your doctor may suggest you have denosumab. It can strengthen the bones, lower the risk of fractures and help to control pain.

Find out about denosumab

Read more about cancer that has spread to the bones

Everolimus is a type of cancer growth blocker. It stops some cancer cells from dividing and growing.

You might have everolimus if you have secondary breast cancer that is ​hormone receptor positive​ and ​HER2 negative​ . You have this drug if you are past the menopause (post menopausal). You take it with a hormone therapy drug called exemestane.

Find out more about everolimus

Neratinib belongs to a group of drugs called cancer growth blockers. They work by blocking the signalling processes that cancer cells use to divide.

You have neratinib treatment for ​early stage breast cancer​  if it is:

• ​hormone receptor positive​

• ​HER2 positive​

• and you have already had treatment with trastuzumab within the last year

Read more about neratinib and the possible side effects

Olaparib is a type of targeted drug called a ​PARP inhibitor​ . You might have this if you have a change in the ​BRCA1​ or ​BRCA2​ genes. 

It is for people with ​HER2 negative​ breast cancer who have already had chemotherapy.   

Find out more about olaparib and its side effects

Your doctor might suggest palbociclib if you have locally advanced breast cancer. This means that the cancer has spread into the surrounding area such as the ​lymph nodes​ . 

It is for people who have ​hormone receptor positive​ and ​HER2 negative​ breast cancer. 

You usually have palbociclib in combination with hormone therapy such as anastrozole. 

Read more about palbociclib and its side effects

Pembrolizumab is a type of immunotherapy. It is a possible treatment for people with ​triple negative breast cancer.​

You usually have pembrolizumab with chemotherapy before surgery (neo adjuvant treatment). This is to reduce the size of the cancer before surgery. You then continue to have it on its own after your surgery (adjuvant treatment).

Read more about pembrolizumab and its symptoms

Pertuzumab is also called Perjeta. It is a type of ​monoclonal antibody​ . You might have it if you have ​HER2 positive​ breast cancer.

You usually have pertuzumab alongside other drug treatments such as trastuzumab and chemotherapy if you have:

• early breast cancer that is at high risk of coming back

• breast cancer that has spread to surrounding tissue (locally advanced breast cancer)

• a rare type of breast cancer called inflammatory breast cancer

• cancer spread in the ​lymph nodes​

Find out more about pertuzumab and its side effects

Ribociclib is a type of targeted cancer drug called a ​cancer growth blocker​ . You might have it if you have ​hormone receptor positive​ and ​HER2 negative​ breast cancer. 

You usually have ribociclib in combination with hormone therapy such as anastrozole. 

Find out more about ribociclib and its side effects

Sacituzumab govitecan is a type of targeted drug. It’s for people with breast cancer that has spread to surrounding tissue (locally advanced). Or for people whose cancer has spread to other parts of the body (secondary breast cancer) and is:

• a type called triple negative breast cancer and

• not suitable for surgery

You must have had two or more drug treatments beforehand. This must include treatment for secondary breast cancer.

Find out more about having sacituzumab govitecan

Talazoparib is a type of targeted drug called a ​PARP inhibitor​ .

It’s for people with ​HER2 negative​ breast cancer who have an abnormal change (mutation) in the ​BRCA1​ or ​BRCA2​ genes.

You might have this if your breast cancer has spread to surrounding tissue (locally advanced). Or if it has spread to other parts of the body (secondary breast cancer).

To have talazoparib you usually must already have had:

• hormone therapy for ​hormone receptor positive​ breast cancer

• a type of chemotherapy called an ​anthracycline​ or ​taxane​ or both

You might be able to have talazoparib if you were unable to have the treatments above.

Find out more about having talazoparib

Trastuzumab is a type of ​monoclonal antibody​ also known by its brand name Herceptin, Herzuma and Ontruzant. It is a treatment for ​HER2 positive​ breast cancer.

You might have trastuzumab:

• on its own

• in combination with other drug treatments such as chemotherapy, hormone therapy or another type of targeted drug

• with other treatments, such as radiotherapy

You might have it before or after surgery. 

Find out more about trastuzumab and its side effects

This treatment is made up of 2 drugs, trastuzumab and deruxtecan.

You might have this if you have ​HER2 positive​ breast cancer that:

• cannot be removed by surgery (unresectable) or

• has spread to other parts of the body (secondary breast cancer)

It's for people who have already had treatment for HER2 positive breast cancer. 

Some people with breast cancer that has low levels of HER2 (HER2 low breast cancer) may have trastuzumab deruxtecan for unresectable or secondary breast cancer, if they have already had chemotherapy. Or if the cancer has come back during ​adjuvant​ chemotherapy, or within 6 months of finishing it. This is available on the NHS in Scotland. But it hasn't been approved for use on the NHS in England, Wales and Northern Ireland.

Find out about trastuzumab deruxtecan (Enhertu) and its side effects

Read about how the NHS decides to fund new treatments

Trastuzumab emtansine (Kadcyla) is a combination of 2 drugs:

• trastuzumab 

• a chemotherapy drug called emsatine

It is a treatment for HER2 positive ​early stage breast cancer​ after surgery. It is only for people who had drug treatment before surgery. And when they had the operation the surgeon found cancer cells nearby either in the breast or lymph nodes.

Trastuzumab emtansine works by finding and attaching itself to the HER2 protein on the surface of the cancer cell. The emtansine then goes inside the cancer cell to destroy it.

Find out more about trastuzumab emtansine (Kadcyla) and its side effects

Tucatinib is a type of targeted drug called a ​tyrosine kinase inhibitor​ . You usually have tucatinib in combination with: 

• trastuzumab

• capecitabine

You might have these drugs if you have ​HER2 positive​ breast cancer that has spread to:

• surrounding tissue (locally advanced) or

• other parts of the body (secondary breast cancer)

You must have already had 2 or more treatments for HER2 positive breast cancer before having this treatment.

Find out more about tucatinib, trastuzumab and capecitabine