German Breast Group GBG Forschungs GmbH, Neu-Isenburg, Germany.
Oncology (Williston Park). 2012 Jan;26(1):20-6.
Neoadjuvant treatment with a sequential anthracycline-taxane-based chemotherapy in combination with trastuzumab (Herceptin) is currently a preferred therapy for patients with HER2-positive breast cancer. This approach is based on the higher pathologic complete response (pCR) of 40% seen with the addition of trastuzumab, compared with a 17% pCR with chemotherapy alone. The pCR can be increased to 75% with dual HER2-receptor blockade and chemotherapy. Higher pCR rates are found in hormone-receptor-negative tumors. Patients with a pCR after chemotherapy and trastuzumab showed a significantly better outcome compared with those who did not have a pCR. The need for additional or alternate treatment options is great in patients who do not achieve a pCR. Addition of lapatinib (Tykerb) or pertuzumab (Omnitarg) to trastuzumab is a therapeutic option. Recent findings suggest pCR might not be the appropriate surrogate for long-term outcome in patients with hormone receptor-positive and HER2-positive tumors.
新辅助治疗采用序贯蒽环类药物-紫杉类药物化疗联合曲妥珠单抗（赫赛汀），目前是治疗人表皮生长因子受体 2（HER2）阳性乳腺癌患者的首选方法。这种方法的依据是，与单独化疗相比，添加曲妥珠单抗可使病理完全缓解率（pCR）从 17%提高到 40%。双重 HER2 受体阻断和化疗可将 pCR 提高到 75%。激素受体阴性肿瘤中 pCR 率更高。与未达到 pCR 的患者相比，化疗和曲妥珠单抗治疗后 pCR 的患者预后显著改善。对于未达到 pCR 的患者，需要额外或替代治疗选择。曲妥珠单抗联合拉帕替尼（泰立沙）或帕妥珠单抗（帕捷特）是一种治疗选择。最近的研究结果表明，对于激素受体阳性和 HER2 阳性肿瘤患者，pCR 可能不是长期预后的合适替代指标。
