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HER2阳性乳腺癌——脑转移的当前治疗管理及新治疗方法

HER2-Positive Breast Cancer-Current Treatment Management and New Therapeutic Methods for Brain Metastasis.

作者信息

Miski Hanna, Krupa Kamila, Budzik Michał Piotr, Deptała Andrzej, Badowska-Kozakiewicz Anna

机构信息

Students' Scientific Organization of Cancer Cell Biology, Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland.

Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland.

出版信息

Biomedicines. 2025 May 9;13(5):1153. doi: 10.3390/biomedicines13051153.

Abstract

: Breast cancer can be classified based on the immunohistochemistry (IHC) phenotypes, defined by the presence or absence of the main IHC markers. IHC phenotyping is important as it determines the prognosis and guides treatment. For example, human epidermal growth factor receptor 2 (HER2) overexpression, which triggers cell growth and division, is observed in HER2-positive breast cancer. : The standard treatment is based on trastuzumab plus pertuzumab in combination with taxane chemotherapy. The possibility of developing metastases depends on those phenotypes. Approximately 25-50% of patients with HER2-positive breast cancer experience brain metastases. This aspect is especially important, as 20% of those patients die as a result. : Through the years, many advanced therapies have been introduced to treat brain metastases, including whole brain radiotherapy, stereotactic radiosurgery, and a tyrosine kinase inhibitor (TKI), neratinib. Nonetheless, this still remains a therapeutic challenge. : In this review, we focus on the treatment and efficiency of therapies targeting HER2-positive breast cancer, mainly concentrating on the current and newly developed treatment options for brain metastases, such as trastuzumab deruxtecan and tucatinib.

摘要

乳腺癌可根据免疫组织化学(IHC)表型进行分类,该表型由主要IHC标志物的存在与否来定义。免疫组织化学表型分析很重要,因为它决定预后并指导治疗。例如,在HER2阳性乳腺癌中可观察到人类表皮生长因子受体2(HER2)过表达,其会触发细胞生长和分裂。标准治疗方案是曲妥珠单抗加帕妥珠单抗联合紫杉烷化疗。发生转移的可能性取决于这些表型。大约25%至50%的HER2阳性乳腺癌患者会发生脑转移。这一点尤为重要,因为其中20%的患者会因此死亡。多年来,已经引入了许多先进疗法来治疗脑转移,包括全脑放疗、立体定向放射外科手术以及一种酪氨酸激酶抑制剂(TKI)奈拉替尼。尽管如此,这仍然是一个治疗挑战。在本综述中,我们聚焦于针对HER2阳性乳腺癌的治疗及其疗效,主要关注脑转移的当前及新开发的治疗选择,如曲妥珠单抗德曲妥珠单抗和图卡替尼。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fd3/12109299/c09d7958d164/biomedicines-13-01153-g001.jpg

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