Hyper-activation of the HER family receptors, leads to up-regulation of the three vital signaling pathways, such as PI3K-AKT or MAPK pathways. It has been demonstrated that one of the reason for resistant development to anti-cancer therapeutic agent, such as trastuzumab, can be HER2 dimerization and/ or formation of heterodimer between HER family receptors.
However, the overexpressed HER family receptors may for heterodimers or co-expressed with some other receptors in breast cancer cells and subsequently cause the development of resistance. For example, HER2 and IGFR-1 heterodimeriztion in breast cancer may have significant role in resistance to therapeutic agents.