Mokbel K, Hassanally D
St George's Hospital, Blackshaw Road, London SW17 0QT, UK.
Curr Med Res Opin. 2001;17(1):51-9. doi: 10.1185/0300799039117027.
HER2 overexpression occurs in 25% of breast cancers and seems to correlate with poor prognosis. HER2 overexpression may predict tamoxifen failure and different response rates to chemotherapeutic agents such as the taxanes and anthracyclines. The detection of HER2 and its overexpression is performed using fluorescent in situ hybridisation (FISH) and/or immunohistochemistry (IHC). Trastuzumab [Herceptin (H)] is a humanised IgG monoclonal antibody specific for the growth factor receptor HER2. Pre-clinical trials using monoclonal antibodies have shown inhibition of breast tumour growth in athymic nude mice. Phase II and III clinical trials have evaluated the efficacy and safety of Herceptin in women with metastatic breast cancer in combination with other agents and as a single agent. Currently, Trastuzumab and paclitaxel is the only combination indicated for the treatment of patients with metastatic breast cancer whose tumours overexpress HER2. It is also indicated as a single agent in women with HER2-overexpressing metastatic breast cancer that has progressed after previous chemotherapy. Herceptin is a well-tolerated drug and the side-effects that are commonly seen with chemotherapy, such as neutropenia, alopecia and mucositis, are rarely observed. The main risk factors for cardiotoxicity are concurrent or previous anthracycline exposure. The potential role of Herceptin in the adjuvant setting is currently being evaluated.
HER2过表达见于25%的乳腺癌患者，且似乎与预后不良相关。HER2过表达可能预示他莫昔芬治疗失败以及对紫杉烷类和蒽环类等化疗药物的不同反应率。HER2及其过表达的检测采用荧光原位杂交（FISH）和/或免疫组织化学（IHC）方法。曲妥珠单抗[赫赛汀（H）]是一种针对生长因子受体HER2的人源化IgG单克隆抗体。使用单克隆抗体的临床前试验已显示对无胸腺裸鼠乳腺肿瘤生长有抑制作用。II期和III期临床试验评估了赫赛汀与其他药物联合及单药治疗转移性乳腺癌女性患者的疗效和安全性。目前，曲妥珠单抗和紫杉醇是唯一被批准用于治疗HER2过表达转移性乳腺癌患者的联合方案。它也被批准作为单药用于既往化疗后进展的HER2过表达转移性乳腺癌女性患者。赫赛汀耐受性良好，很少出现化疗常见的副作用，如中性粒细胞减少、脱发和粘膜炎。心脏毒性的主要危险因素是同时或既往使用过蒽环类药物。目前正在评估赫赛汀在辅助治疗中的潜在作用。
