Department of Medical Oncology, Ospedale Sacro Cuore Don Calabria, Negrar, Italy.
Oncology. 2009;77 Suppl 1:14-7. doi: 10.1159/000258491. Epub 2010 Feb 2.
HER2-positive breast cancer is characterized by high chemosensitivity. Anthracycline-based chemotherapy is recognized as a very effective adjuvant treatment in HER2-positive disease. One of the possible explanations is the co-amplification of TOPO II-alpha and HER2. However, recent data seem to demonstrate that HER2 and TOPO II-alpha seem to be less predictive of anthracycline-based chemotherapy efficacy than chromosome 17 polysomy. Chromosome 17 polysomy is present in 21-40% of breast cancer and for this reason benefit of anthracycline-based chemotherapy seems to be not restricted only to HER2-positive disease. Trastuzumab added to chemotherapy administered for one year is associated with improvement in disease-free survival and sometimes in overall survival compared to chemotherapy alone. Efficacy of trastuzumab in the adjuvant setting seems to be increased if administered concomitantly with chemotherapy instead of sequentially. However, the interpretation of longer follow-up results is difficult because of a large crossover from the control arm to trastuzumab.
人表皮生长因子受体 2 阳性乳腺癌的特点是对化疗高度敏感。蒽环类药物为基础的化疗被认为是 HER2 阳性疾病非常有效的辅助治疗。一种可能的解释是拓扑异构酶 II-α和 HER2 的共同扩增。然而，最近的数据似乎表明，HER2 和拓扑异构酶 II-α似乎比 17 号染色体三体性对蒽环类药物化疗的疗效预测性差。17 号染色体三体性存在于 21-40%的乳腺癌中，因此蒽环类药物化疗的获益似乎不仅局限于 HER2 阳性疾病。曲妥珠单抗联合化疗治疗一年与单纯化疗相比，无病生存率和总生存率有所提高。曲妥珠单抗在辅助治疗中的疗效似乎随着与化疗同时给药而不是序贯给药而增加。然而，由于从对照组到曲妥珠单抗的大量交叉，更长随访结果的解释变得困难。
