a Oncology Medicine Department , Jules Bordet Institute, Université Libre de Bruxelles.
Expert Rev Anticancer Ther. 2019 Jun;19(6):447-454. doi: 10.1080/14737140.2019.1613892. Epub 2019 May 13.
: Breast cancer (BC) is the most common cancer in women. Human epidermal growth factor receptor 2-positive (HER2-positive) BC represents up to 15% of all BC cases and is associated with a poor prognosis. Despite the substantial improvement obtained with the addition to the treatment of trastuzumab in this subtype of BC, disease recurrence can still occur. : Anti-HER2 targeting drugs such as trastuzumab, pertuzumab, and T-DM1 have shown significant results in (neo)adjuvant setting. In this article, we will focus on available data for neratinib to reduce BC recurrence based mainly on the results of the ExteNET trial. This trial aimed to investigate whether neratinib can further reduce the risk of recurrence of patients diagnosed with HER2-positive BC. This trial demonstrated a significant reduction in the risk of invasive disease-free survival, particularly in hormone receptor-positive population. In addition, this review provides an expert opinion and analysis of the current situation in the adjuvant HER2-positive BC setting and in particular the escalation strategy of HER2 targeting. : The treatment landscape of HER2 positive BC in this setting will evolve in the coming years with a need for clinical and molecular perspective tools to guide therapy.
乳腺癌（BC）是女性中最常见的癌症。人表皮生长因子受体 2 阳性（HER2 阳性）BC 约占所有 BC 病例的 15%，并与预后不良相关。尽管在这种 BC 亚型的治疗中加入曲妥珠单抗后取得了实质性的改善，但疾病仍可能复发。针对 HER2 的靶向药物，如曲妥珠单抗、帕妥珠单抗和 T-DM1，在（新）辅助治疗中显示出显著的效果。在本文中，我们将主要根据 ExteNET 试验的结果，重点关注奈拉替尼在降低 BC 复发风险方面的现有数据。该试验旨在研究奈拉替尼是否可以进一步降低 HER2 阳性 BC 患者的复发风险。该试验表明，无侵袭性疾病的生存显著降低，特别是在激素受体阳性人群中。此外，本综述提供了对辅助 HER2 阳性 BC 环境中当前情况的专家意见和分析，特别是 HER2 靶向治疗的升级策略。在未来几年，该环境中 HER2 阳性 BC 的治疗格局将发生变化，需要临床和分子视角的工具来指导治疗。
