Breast Cancer Treatment in China: HER2-Targeted Therapy, CDK4/6 Inhibitors, PARP Inhibitors, TNBC Immunotherapy, and China-Developed Innovative Drugs for International Patients

Why China's Breast Cancer Caseload Matters

Breast cancer is the most commonly diagnosed cancer among women in China, with incidence rising particularly rapidly in urban populations over the past two decades. At major oncology centres in Beijing, Shanghai, and other cities, breast cancer specialists may see hundreds of new patients annually — a volume that creates deep familiarity with all subtypes, including less common presentations and complex cases that require multi-line treatment sequencing.

One clinically relevant characteristic of breast cancer in China is that patients are often diagnosed at a younger average age than in Western populations. This influences treatment approaches: neoadjuvant (pre-surgery) chemotherapy is widely used to assess treatment response and guide adjuvant planning, and fertility considerations are discussed routinely at large centres for premenopausal patients.

For international patients seeking a structured second opinion or MDT review of a breast cancer diagnosis or treatment plan, Chinese specialist teams have relevant experience across all treatment lines and subtypes.

Biomarker Profiling: The Foundation of Breast Cancer Treatment Decisions

Breast cancer is not a single disease. Treatment is determined by the tumour's molecular subtype and biomarker profile. At experienced Chinese cancer centres, standard testing at diagnosis includes:

Comprehensive genomic profiling (NGS panel testing) is increasingly performed at leading Chinese centres for metastatic breast cancer, identifying additional actionable alterations beyond the standard panel — including RET fusions, NTRK fusions, TMB-high status, and somatic BRCA alterations.

HER2-Positive Breast Cancer: International Drugs and China-Developed Agents

HER2-positive breast cancer has been transformed over the past two decades by targeted therapies. China offers access to the full range of globally approved agents plus several China-developed drugs that are not available in many other countries.

HR-Positive / HER2-Negative Breast Cancer: Endocrine Therapy and CDK4/6 Inhibitors

Hormone receptor-positive, HER2-negative breast cancer is the most common subtype globally and in China. The standard treatment approach combines endocrine therapy (tamoxifen or aromatase inhibitors) with CDK4/6 inhibitors in the metastatic setting, based on consistently demonstrated progression-free and overall survival benefits in multiple large Phase III trials.

China has access to all three internationally approved CDK4/6 inhibitors — palbociclib (帕博西利 / 爱博新), ribociclib (瑞博西利), and abemaciclib (阿贝西利 / 唯择) — as well as a domestically developed agent:

For premenopausal patients, ovarian function suppression combined with endocrine therapy and CDK4/6 inhibitors is standard practice. Alpelisib (阿培利司), a PIK3CA inhibitor, is available for PIK3CA-mutated HR+/HER2-negative metastatic disease after endocrine therapy progression.

Triple-Negative Breast Cancer (TNBC): Immunotherapy and ADC Approaches

Triple-negative breast cancer — lacking oestrogen receptor, progesterone receptor, and HER2 expression — is the most challenging subtype, historically treated with chemotherapy alone. Two treatment categories have significantly changed the TNBC landscape in recent years, both of which are available in China.

Antibody-Drug Conjugates: The New Wave in Breast Cancer Treatment

Antibody-drug conjugates (ADCs) — drugs that link a targeted antibody to a cytotoxic payload — have become one of the most rapidly advancing areas in breast cancer over the past five years. China has access to the major approved ADCs and has its own ADC development programs.

The concept of "HER2-low" breast cancer — tumours with IHC 1+ or 2+/FISH-negative HER2 expression, previously considered HER2-negative — has been validated as a clinically distinct group that responds to DS-8201. This expanded the proportion of breast cancer patients potentially eligible for HER2-directed ADC therapy from approximately 20% to roughly 55–60% of all breast cancers. At major Chinese centres, HER2 IHC scoring to distinguish HER2-low from HER2-zero is now performed routinely.

MDT Evaluation and Second Opinion for Breast Cancer

Breast cancer treatment decisions — particularly around treatment sequencing, drug combinations, and emerging eligibility criteria like HER2-low and PIK3CA mutation status — benefit from multidisciplinary input. Major Chinese cancer centres conduct structured MDT case reviews bringing together medical oncologists, breast surgeons, radiation oncologists, pathologists, and imaging specialists.

An online MDT consultation for breast cancer patients can include:

• Review of pathology and biomarker results — with identification of any additional testing that may expand treatment options (e.g. HER2 IHC re-review for HER2-low status, PIK3CA mutation testing, germline BRCA testing)
• Assessment of prior treatment history and sequencing of remaining standard options
• Identification of China-developed drugs or clinical trials for which the patient may be eligible
• Practical logistics guidance if in-person assessment or treatment in China is being considered

Patients exploring cancer treatment coordination in China can be connected with breast cancer specialists at leading centres through a structured coordination pathway.

Supportive Care During Breast Cancer Treatment in China

Major Chinese cancer centres integrate supportive care into active breast cancer treatment programs. For patients undergoing chemotherapy, HER2-targeted therapy, or CDK4/6 inhibitors, supportive care addresses common side effects including fatigue, nausea, peripheral neuropathy, bone health, and the emotional demands of treatment.

Integrative approaches available at Chinese oncology centres — including Traditional Chinese Medicine supportive care — may be offered alongside standard treatment. Acupuncture has been studied for chemotherapy-induced nausea, aromatase inhibitor-associated joint pain, and cancer-related fatigue. These approaches are used as complementary support — not as alternatives to evidence-based breast cancer treatment.