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Life sciences · Journal article
Journal of Clinical Technology and Theory. · October 12, 2026
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Breast cancer ranks among the most common malignancies affecting women globally, and can be stratified into multiple molecular subtypes that guide the selection of targeted therapeutic strategies. This review systematically compares two representative targeted agents: trastuzumab and abemaciclib, which act via completely different therapeutic paradigms for HER2+ and HR+/HER2- breast cancer respectively. Trastuzumab is a humanized intravenous monoclonal antibody targeting membrane HER2 extracellular domain IV, suppressing oncogenic HER2 signaling and exerting anti-tumour effects mainly through antibody-dependent cellular cytotoxicity, while its primary adverse effect is cardiac toxicity. Abemaciclib is an oral small‑molecule CDK4/6 inhibitor capable of arresting G1/S cell‑cycle shift via suppression of cyclin D‑CDK4/6 kinase activity, with diarrhea and neutropenia as its major toxicities. Building upon published clinical evidence, this review contrasts their clinical applicability, efficacy and safety profiles across patient subgroups. It also outlines core resistance mechanisms underlying treatment failure for both modalities, highlighting key molecular differences that separate antibody based HER2-directed therapy from cell-cycle-targeted small-molecule inhibition. Despite both occupying critical positions in modern breast cancer treatment, the two agents are not interchangeable given their divergent targets, toxicity spectra and eligible patient populations. Integrating such comparative information supports better therapeutic decision-making and promotes personalized precision oncology for breast cancer patients.