Prior Lisa, Lim Marvin, Ward Cian, Featherstone Hannah, Murray Hazel, D'Arcy Clare, Crown John, Gullo Giuseppe
Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland.
Pathology, St Vincent's University Hospital, Dublin, Ireland.
Cureus. 2017 Sep 5;9(9):e1654. doi: 10.7759/cureus.1654.
The advent of trastuzumab and other human epidermal growth factor receptor 2 (HER2)-directed therapies has revolutionized the treatment of metastatic HER2-positive breast cancer, leading to prolonged survival and appreciable clinical benefit for a substantial subset of patients. Previously, in a retrospective study at our institution, we observed that nearly 10% of patients achieved a durable complete remission (DCR) following a combination of HER2-directed therapy and cytotoxic chemotherapy. We are currently expanding this study to include patients who were treated since the initial introduction of trastuzumab. From our ongoing study, we present a selected case series of three patients with metastatic HER2-positive breast cancer who achieved a DCR. It is theorized that metastatic HER2-positive breast cancer may be potentially curable in certain patients with favorable clinicopathological and molecular factors, which the patients within our case series mostly demonstrate. These include de novo presentation, estrogen receptor (ER)-negative status, limited disease burden, and absence of deleterious gene or pathway mutations. More research is needed in order to incorporate these findings into clinical practice.
曲妥珠单抗及其他针对人表皮生长因子受体2（HER2）的疗法的出现，彻底改变了转移性HER2阳性乳腺癌的治疗方式，使相当一部分患者的生存期延长，并获得了显著的临床益处。此前，在我们机构进行的一项回顾性研究中，我们观察到，近10%的患者在接受HER2靶向治疗和细胞毒性化疗联合治疗后实现了持久完全缓解（DCR）。我们目前正在扩大这项研究，纳入自曲妥珠单抗首次应用以来接受治疗的患者。在我们正在进行的研究中，我们展示了一组精选的3例转移性HER2阳性乳腺癌患者实现DCR的病例系列。理论上，某些具有有利临床病理和分子因素的转移性HER2阳性乳腺癌患者可能有潜在治愈的可能，我们病例系列中的患者大多具备这些因素。这些因素包括初发表现、雌激素受体（ER）阴性状态、疾病负担有限，以及不存在有害基因或通路突变。为了将这些发现应用于临床实践，还需要更多的研究。
