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[在 IIIB 期不可手术的局部晚期 HER2 阳性乳腺癌中使用曲妥珠单抗和每周一次紫杉醇进行术前治疗并获得完全病理缓解]

[Preoperative therapy using trastuzumab and weekly paclitaxel in a stage IIIB inoperable locally advanced HER2- positive breast cancer with complete pathologic response].

作者信息

Rai Yoshiaki, Sagara Yoshiatsu, Ooi Yasuyo, Sagara Yasuaki, Sagara Yoshiaki, Baba Shinichi, Tamada Syugo, Matsuyama Yoshito, Ando Mitsutake

机构信息

Dept. of Breast Surgery, Sagara Hospital.

出版信息

Gan To Kagaku Ryoho. 2009 Mar;36(3):471-3.

Abstract

A 63-year-old woman had a 12 cm tumor on her right breast with broad skin redness, satellite lesions and 8 cm ipsilateral lymph nodes swelling(T4bN2aM0, Stage IIIB). Core needle biopsy and immunohistochemistry of breast tumor showed invasive ductal carcinoma with negative hormone receptor(ER-, PgR-)and overexpression of HER2 (HercepTest 3+). She was treated with weekly paclitaxel(80 mg/m(2), 4 administrations with a week rest)and a com- bination with weekly trastuzumab(initially 4 mg/kg followed by 2 mg/kg every week, totally 11 administrations). After 3courses of administration, the breast tumor, skin redness and axillary swelling were completely disappeared(clinical complete response), then mastectomy with axillary dissection was performed. Histopathology of the breast and lymph nodes showed complete disappear of invasive cancer cells with only 2x1 mm residue of ductal component(pCR, grade 3, DC+). We conclude that the combination of weekly paclitaxel and trastuzumab is a promising neoadjuvant therapy regimen for HER2 positive, ER-negative breast cancer.

摘要

一名63岁女性右乳有一个12厘米的肿瘤,伴有广泛的皮肤发红、卫星病灶以及同侧8厘米的淋巴结肿大(T4bN2aM0,IIIB期)。乳腺肿瘤的粗针活检及免疫组化显示为浸润性导管癌,激素受体阴性(ER-,PgR-),HER2过表达(HercepTest 3+)。她接受了每周一次的紫杉醇治疗(80毫克/平方米,共4次给药,中间休息一周),并联合每周一次的曲妥珠单抗(初始剂量4毫克/千克,随后每周2毫克/千克,共11次给药)。给药3个疗程后,乳腺肿瘤、皮肤发红及腋窝肿胀完全消失(临床完全缓解),随后进行了乳房切除术及腋窝淋巴结清扫术。乳腺及淋巴结的组织病理学检查显示浸润性癌细胞完全消失,仅残留2×1毫米的导管成分(pCR,3级,DC+)。我们得出结论,每周一次的紫杉醇与曲妥珠单抗联合是HER2阳性、ER阴性乳腺癌一种有前景的新辅助治疗方案。

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