Olson Erin, Mullins D'Anna
Clinical Fellow, Divisions of Medical Oncology and Hematology, The Wexner Medical Center at the Ohio State University, USA.
J Clin Trials. 2013 Mar 6;3:1000129. doi: 10.4172/2167-0870.1000129.
The area of HER2-positive breast cancer is a rapidly changing field. The use of the humanized monoclonal antibody, trastuzumab, significantly improved the prognosis for patients with HER2-positive breast cancer, however, increasing knowledge regarding mechanisms of resistance to trastuzumab have come to light, prompting research into additional methods to target the HER2 protein. The purpose of this article is to discuss evidence for why continued blockade of the HER2 pathway continues to be important despite progression on trastuzumab, as well as to review additional HER2-targeted therapies and progression in the central nervous system. With the availability of new drugs comes the need to determine the appropriate therapeutic combinations and optimal order in which to deliver these therapies. This review summarizes the practice-changing phase III trials and some supporting phase II data regarding the various targeted HER2 therapies available for patients with advanced HER2-positive breast cancer, proposes order for anti-HER2 therapy in the advanced HER2-positive breast cancer patient, and includes information on future strategies. While other reviews on HER2-targeted therapy are available, this review specifically aims at addressing treatment options after trastuzumab failure in the patient with advanced HER2-positive breast cancer.
人表皮生长因子受体2（HER2）阳性乳腺癌领域是一个快速变化的领域。人源化单克隆抗体曲妥珠单抗的应用显著改善了HER2阳性乳腺癌患者的预后，然而，关于曲妥珠单抗耐药机制的认识不断深入，促使人们研究针对HER2蛋白的其他方法。本文旨在讨论尽管曲妥珠单抗治疗取得进展，但持续阻断HER2通路为何仍然重要的证据，并综述其他HER2靶向治疗方法以及在中枢神经系统中的进展。随着新药的出现，需要确定合适的治疗组合以及提供这些治疗的最佳顺序。本综述总结了改变实践的III期试验以及一些支持性的II期数据，这些数据涉及可用于晚期HER2阳性乳腺癌患者的各种HER2靶向治疗方法，提出了晚期HER2阳性乳腺癌患者抗HER2治疗的顺序，并包括未来策略的信息。虽然有其他关于HER2靶向治疗的综述，但本综述专门针对晚期HER2阳性乳腺癌患者曲妥珠单抗治疗失败后的治疗选择。
