HER2阳性乳腺癌新辅助治疗现状综述
Review of the status of neoadjuvant therapy in HER2-positive breast cancer.
作者信息
Dowling Gavin P, Keelan Stephen, Toomey Sinead, Daly Gordon R, Hennessy Bryan T, Hill Arnold D K
机构信息
Medical Oncology Lab, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
The Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.
出版信息
Front Oncol. 2023 Jan 30;13:1066007. doi: 10.3389/fonc.2023.1066007. eCollection 2023.
Abstract
PURPOSE
The development of human epidermal growth factor receptor 2 (HER2)-directed therapies has revolutionized the treatment of HER2-positive breast cancer. The aim of this article is to review the continually evolving treatment strategies in the neoadjuvant setting of HER2-positive breast cancer, as well as the current challenges and future perspectives.
METHODS
Searches were undertaken on PubMed and Clinicaltrials.gov for relevant publications and trials.
FINDINGS
The current standard of care in high-risk HER2-positive breast cancer is to combine chemotherapy with dual anti-HER2 therapy, for a synergistic anti-tumor effect. We discuss the pivotal trials which led to the adoption of this approach, as well as the benefit of these neoadjuvant strategies for guiding appropriate adjuvant therapy. De-escalation strategies are currently being investigated to avoid over treatment, and aim to safely reduce chemotherapy, while optimizing HER2-targeted therapies. The development and validation of a reliable biomarker is essential to enable these de-escalation strategies and personalization of treatment. In addition, promising novel therapies are currently being explored to further improve outcomes in HER2-positive breast cancer.
摘要
目的
人表皮生长因子受体2（HER2）导向疗法的发展彻底改变了HER2阳性乳腺癌的治疗方式。本文旨在综述HER2阳性乳腺癌新辅助治疗中不断演变的治疗策略，以及当前面临的挑战和未来展望。
方法
在PubMed和Clinicaltrials.gov上检索相关出版物和试验。
研究结果
高危HER2阳性乳腺癌目前的标准治疗方案是将化疗与双重抗HER2治疗联合使用，以产生协同抗肿瘤效果。我们讨论了促成采用这种方法的关键试验，以及这些新辅助治疗策略在指导适当辅助治疗方面的益处。目前正在研究降阶梯策略以避免过度治疗，其目的是在优化HER2靶向治疗的同时安全地减少化疗。开发和验证可靠的生物标志物对于实现这些降阶梯策略和治疗个体化至关重要。此外，目前正在探索有前景的新型疗法，以进一步改善HER2阳性乳腺癌的治疗效果。
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