Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Pharmacotherapy. 2014 Jan;34(1):60-71. doi: 10.1002/phar.1338. Epub 2013 Aug 5.
Trastuzumab, a humanized monoclonal antibody, has become an important targeted therapy for patients with all stages of human epidermal growth factor receptor-2 (HER2)-positive breast cancer. However, primary and acquired resistance to trastuzumab remains a significant problem. Pertuzumab, a humanized monoclonal antibody that binds to a domain of the HER2 receptor separate from trastuzumab, may have the potential to overcome trastuzumab resistance. Clinical trials have shown that pertuzumab can be effectively combined with other biologic therapy or chemotherapy in patients with metastatic HER2-positive breast cancer. Pertuzumab is relatively well tolerated with minimal increases in hematologic and cardiac toxicity observed when added to trastuzumab and/or docetaxel. In addition to becoming the standard of care in combination with docetaxel and trastuzumab in patients with newly diagnosed HER2-positive metastatic breast cancer, clinical trials continue to evaluate pertuzumab in combination with other targeted therapy, chemotherapy, and in patients with early stage breast cancer. These trials will help to further determine the role of pertuzumab in the treatment of HER2-positive breast cancer.
曲妥珠单抗是一种人源化单克隆抗体，已成为各阶段人表皮生长因子受体-2（HER2）阳性乳腺癌患者的重要靶向治疗药物。然而，曲妥珠单抗的原发性和获得性耐药仍然是一个重大问题。帕妥珠单抗是一种人源化单克隆抗体，与曲妥珠单抗结合的 HER2 受体的结构域不同，可能具有克服曲妥珠单抗耐药的潜力。临床试验表明，帕妥珠单抗可与其他生物治疗或化疗联合用于转移性 HER2 阳性乳腺癌患者。与曲妥珠单抗和/或多西他赛联合使用时，帕妥珠单抗耐受性相对较好，仅观察到血液学和心脏毒性略有增加。除了与多西他赛和曲妥珠单抗联合成为新诊断的 HER2 阳性转移性乳腺癌患者的标准治疗方法外，临床试验还在继续评估帕妥珠单抗与其他靶向治疗、化疗以及早期乳腺癌患者的联合应用。这些试验将有助于进一步确定帕妥珠单抗在治疗 HER2 阳性乳腺癌中的作用。
