Neoadjuvant therapy for HER2-positive breast cancer

Author:

Dukić Nikolina,Gojković Zdenka,Lalović Nenad,Vladičić-Mašić Jelena,Jokanović Dragana,Mašić Srđan,Popović Slađana,Čančar Olivera

Abstract

The human epidermal growth receptor 2 (HER2, c-erb-B2) is present in 15-20% of breast cancer at the time of diagnosis. Overexpression of HER2 receptor is associated with more aggressive form of breast cancer. Trastuzumab is a human monoclonal antibody that blocks the signaling pathways of cell proliferation by binding to the HER2 receptor. Due to the possible occurrence of resistance to trastuzumab (binds to the subdomain of II HER2 receptor and thus achieves the ligand-independent inhibition of cell proliferation), another monoclonal antibody pertuzumab was produces in the course of time (binds to the subdomain of IV HER2 receptor and thus achieves the ligand-dependent inhibition of cell proliferation), forming the basis of dual HER2 receptor blockade. Numerous studies have shown the benefits of administering trastuzumab and pertuzumab, initially in metastatic, and then in adjuvant and neoadjuvant regimens. Neoadjuvant (preoperative) therapy is given in inoperable tumors, in patients at high risk of poor outcomes (HER2-positive tumors, nodus positive tumors, inflammatory breast cancer, large tumors), as well as in additional risk factors - HR negative tumors where no beneficial effect is expected from the hormonal therapy in the adjuvant setting. Neoadjuvant therapy also provides an "in vivo" insight into the tumor response to neoadjuvant therapy. A pathological complete response (pCR) is an early parameter of the effectiveness of neoadjuvant therapy which also allows us to discover the sensitivity of the tumor in time and make a decision on adjuvant treatment. pCR has a predictive and prognostic value. Namely, the rate of pCR is associated with desease-free survival and overall survival. On the basis of the rate of pCR, numerous studies have shown that there are subgroups of HER2-positive breast cancer: subgroup of hormone receptor-negative tumors that have a higher response rate to the existing anti-HER2 therapy and HER2-positive breast carcer; the subgroup of hormone-dependent tumors in which an adequate pCR rate is not achieved by existing therapeutic options, which represents a new area of research and the possibility for finding new treatment strategies.

Publisher

Centre for Evaluation in Education and Science (CEON/CEES)

Reference32 articles.

1. Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/ neu oncogene. Science 1987;235:177-82;

2. Gojković Z. Prognostički značaj markera neoangiogeneze kod bolesnica sa karcinomima dojke i uticaj na dužinu vremena do pojave recidiva i udaljenih metastaza. Doktorska disertacija. Univerzitet u Beogradu, 2009;

3. Dukić N. Primjena monoklonskih antitijela u adjuvantnoj terapiji HER 2 pozitivnog karcinoma dojke i uticaj na dužinu vremena do relapsa bolesti. Magistarski rad. Univerzitet u Istočnom Sarajevu, 2015;

4. Moja L, Tagliabue L, Balduzzi S, Parmelli E, Pistotti V, Guarneri V, et al. Trastuzumab containing regimens for early breast cancer. Cochrane Database Syst Rev 2012;4: CD006243;

5. Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE Jr, Davidson NE, et al. Trastuzumab plus adjuvant chemotherapyfor operable HER2-positive breast cancer. N Engl J Med 2005;353:1673-84;

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3