Belkacémi Yazid, Gligorov Joseph, Mauriac Louis, Azria David
Département d'Oncologie-Radiothérapie, CRLCC Oscar-Lambret, Lille.
Bull Cancer. 2006 Oct;93(10):991-9.
One of the most recent advances in the management of Her-2/neu positive breast cancer is the validation of a targeted therapy from bench to the clinic, particularly towards the adjuvant setting. The recommended dose of trastuzumab (Herceptin), a humanized monoclonal antibody targeting the HER-2 antigen, has been determined in phase I studies. In the metastatic patients two randomised trials have demonstrated its efficacy when associated to taxanes. In less than 10 years, trastuzumab became the standard of care in the adjuvant treatment of HER-2/neu positive breast cancer. In this setting, two combinations regimen with chemotherapy (concomitant or sequential) have been recently published. The concomitant schedule has been used in three studies (North American Group, BCIRG, FinHer), whereas in the Hera trial trastuzumab was started after the end of neo-adjuvant and adjuvant chemotherapy. In this article, the advantages and uncertainties on efficacy and toxicities of the trastuzumab administration modalities, associated or not to chemotherapy and radiation therapy, are discussed.
人表皮生长因子受体2（Her-2/neu）阳性乳腺癌治疗的最新进展之一是一种靶向治疗方法从实验室到临床的验证，尤其是在辅助治疗方面。针对HER-2抗原的人源化单克隆抗体曲妥珠单抗（赫赛汀）的推荐剂量已在I期研究中确定。在转移性患者中，两项随机试验证明了其与紫杉烷类联合使用时的疗效。在不到10年的时间里，曲妥珠单抗成为HER-2/neu阳性乳腺癌辅助治疗的标准疗法。在这种情况下，最近公布了两种化疗联合方案（同步或序贯）。同步方案已在三项研究（北美组、BCIRG、芬兰乳腺癌研究组）中使用，而在Hera试验中，曲妥珠单抗在新辅助化疗和辅助化疗结束后开始使用。本文讨论了曲妥珠单抗给药方式（无论是否与化疗和放疗联合）在疗效和毒性方面的优势与不确定性。
