Bauerfeind Ingo, Elling Dirk, Heinemann Volker
Brustzentrum Klinikum Landshut, Berlin.
Breast Care (Basel). 2010;5(s1):13-15. doi: 10.1159/000285775. Epub 2010 Apr 26.
In women with estrogen receptor(ER)- and ErbB2 (HER2)-positive breast cancer, a vicious cycle is established between ER mechanisms of action and the growth factor receptor network, leading to enhanced cell proliferation and endocrine resistance. As such, co-targeting ErbB1 and ErbB2 with lapatinib in combination with hormonal therapy is an attractive approach to enhance the efficacy of either tamoxifen or estrogen deprivation. As demonstrated in the EGF30008 trial, a combined targeted strategy with letrozole and lapatinib significantly increased progression-free survival and clinical benefit rates in patients with metastatic breast cancer that co-expresses ER and ErbB2. Therefore, women who are not in an acutely life-threatening situation should be considered for upfront treatment with hormonal therapy (e.g. aromatase inhibitors) in combination with an anti-ErbB2 therapy.
在雌激素受体(ER)和表皮生长因子受体2(ErbB2,HER2)阳性的乳腺癌女性患者中,ER作用机制与生长因子受体网络之间形成了恶性循环,导致细胞增殖增强和内分泌抵抗。因此,将拉帕替尼与ErbB1和ErbB2共同靶向,并联合激素治疗,是增强他莫昔芬或雌激素剥夺疗效的一种有吸引力的方法。如EGF30008试验所示,来曲唑与拉帕替尼联合的靶向治疗策略显著提高了共表达ER和ErbB2的转移性乳腺癌患者的无进展生存期和临床获益率。因此,对于未处于急性危及生命状况的女性,应考虑采用激素治疗(如芳香化酶抑制剂)联合抗ErbB2治疗进行初始治疗。