Takuwa Haruko, Tsuji Wakako, Yotsumoto Fumiaki
Department of Breast Surgery, Shiga General Hospital, 5-4-30, Moriyama, Moriyama-city, Shiga, 524-8524, Japan.
Int J Surg Case Rep. 2018;52:125-131. doi: 10.1016/j.ijscr.2018.10.008. Epub 2018 Oct 12.
Human epidermal growth factor receptor 2 (HER2) -positive breast cancers tend to be more aggressive and more likely to recur than HER2-negative breast cancers. However, novel anti-HER2 therapies have dramatically improved the prognosis of patients with HER2-positive breast cancer.
We review the cases of 4 women with metastatic breast cancer who achieved clinical complete response (cCR) and terminated their systemic therapy. Two patients had de novo metastatic disease and two patients experienced relapse after adjuvant therapy. All patients achieved cCR using multidisciplinary therapy, experienced prolonged complete remission, and subsequently terminated their systemic therapy without experiencing secondary recurrence.
There is no evidence that systemic therapy can be safely terminated after a specific time period, although adverse events (e.g., cardiotoxicity) and unnecessary treatment should be avoided. Thus, it is possible that select patients may be suitable for termination of systemic therapy after they have achieved a prolonged period of cCR.
人表皮生长因子受体2（HER2）阳性乳腺癌往往比HER2阴性乳腺癌更具侵袭性，且更易复发。然而，新型抗HER2疗法显著改善了HER2阳性乳腺癌患者的预后。
我们回顾了4例转移性乳腺癌女性患者的病例，这些患者均实现了临床完全缓解（cCR）并终止了全身治疗。2例患者为初发转移性疾病，2例患者在辅助治疗后复发。所有患者通过多学科治疗实现了cCR，经历了长时间的完全缓解，随后终止全身治疗且未出现二次复发。
没有证据表明在特定时间段后可安全终止全身治疗，尽管应避免不良事件（如心脏毒性）和不必要的治疗。因此，部分患者在实现长时间的cCR后有可能适合终止全身治疗。
