Molecule of the Month: HER2/neu and Trastuzumab
Trastuzumab monoclonal antibodies targeting HER2 receptors are at the forefront of breast cancer treatment
The Odd One Out
Exploring the Structure
HER2 with Pertuzumab and Trastuzumab
The availability of two different therapeutic antibodies has a great advantage. Using a combination of trastuzumab and pertuzumab simultaneously, known as Dual-HER2 inhibition, overcomes trastuzumab resistance and may also help suppress development of resistance in patients. When HER2 is attacked in two different locations (as seen here from PDB entry 6oge), it is more difficult for the protein to mutate and become resistant to both therapies at the same time. Additionally, this combination assists in targeting many of the functional elements of HER2 that contribute to the progression of breast cancer. Trastuzumab alone blocks homodimerization, but leaves the HER2 heterodimerization arm functional. In contrast, pertuzumab has the ability to block heterodimerization. The combination reaps the benefits of both arresting cell growth (trastuzumab) and preventing HER2:HER3 activation (pertuzumab). Dual anti-HER2 treatments have been shown to improve outcomes in patients significantly when compared to using a single drug. To explore this structure in more detail, click on the image for an interactive Jsmol.
Topics for Further Discussion
- Many cell-surface receptors transmit signals into the cell by dimerizing. To see other examples, see the Molecule of the Month on Growth Hormone, Epidermal Growth Factors (EGF), and Vascular Endothelial Growth Factor (VegF) .
- Trastuzumab has been chemically-connected to other drugs that attack other molecules, such as the microtubule-binding drug maytansine (PDB ID 4tv8). In the conjugate drug, trastuzumab targets the cancer cell and maytansine kills it.
Related PDB-101 Resources
- Browse Cancer
- Browse Cellular Signaling
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- Ling W.L., Lua W.H., Poh J.J., Yeo J.Y., Lane D.P., Gan S.K. (2018) Effect of VH-VL Families in Pertuzumab and Trastuzumab Recombinant Production, Her2 and FcγIIA Binding. Front Immunol. 9:469.
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- 3pp0: Aertgeerts K., Skene R., Yano J., Sang B.C., Zou H., Snell G., Jennings A., Iwamoto K., Habuka N., Hirokawa A., Ishikawa T., Tanaka T., Miki H., Ohta Y., Sogabe S. (2011) Structural analysis of the mechanism of inhibition and allosteric activation of the kinase domain of HER2 protein. J Biol Chem. 286(21):18756-65.
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- 2ks1: Mineev K.S., Bocharov E.V., Pustovalova Y.E., Bocharova O.V., Chupin V.V., Arseniev A.S. (2010) Spatial structure of the transmembrane domain heterodimer of ErbB1 and ErbB2 receptor tyrosine kinases. J Mol Biol. 400(2):231-43.
- Hudis C.A. (2007) Trastuzumab--mechanism of action and use in clinical practice. N Engl J Med. 357:39-51.
- 1s78: Franklin M.C., Carey K.D., Vajdos F.F., Leahy D.J., de Vos A.M., Sliwkowski M.X. (2004) Insights into ErbB signaling from the structure of the ErbB2-pertuzumab complex. Cancer Cell. 5(4):317-28.
- 1n8z: Cho H.S., Mason K., Ramyar K.X., Stanley A.M., Gabelli S.B., Denney D.W. Jr., Leahy D.J. (2003) Structure of the extracellular region of HER2 alone and in complex with the Herceptin Fab. Nature. 421(6924):756-60.
April 2022, Sol De Leon Cruz, Amber Herrod, Katherine H. Park, Amy Wu Wu, David S. Goodsell, Stephen K. Burleydoi:10.2210/rcsb_pdb/mom_2022_4