NEOADJUVANT CHEMOTHERAPY FOR HER2-POSITIVE BREAST CANCER USING TRASTUZUMAB AND PERTUZUMAB

A.A. Chapanov, A.E. Kоzyakov, V.E. Voytsytskiy, O. A. Tkachuk
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Abstract

Breast cancer is the most common malignant tumor in women. HER2-positive (HER2+) breast cancer is a molecular subtype characterized by an aggressive course, a tendency for tumor cells to spread rapidly, and resistance to standard cytostatic regimens. A number of large randomized trials have shown that the use of neoadjuvant chemotherapy provides the same overall survival rates as adjuvant regimens. In addition, the use of neoadjuvant chemotherapy makes it possible to achieve therapeutic pathomorphosis. The discovery of new chemotherapeutic drugs has made it possible to use a dual blockade of HER2 receptors due to interaction with different subdomains of this protein. In particular, chemotherapy using Trastuzumab, Pertuzumab, and Docetaxel has proven to be an effective regimen to achieve high rates of therapeutic pathomorphosis and survival. The paper analyzes the mechanism of action and effectiveness of the combined use of Trastuzumab and Pertuzumab, presents two clinical cases of practical treatment using dual targeted blockade.
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使用曲妥珠单抗和帕妥珠单抗治疗her2阳性乳腺癌的新辅助化疗
乳腺癌是女性中最常见的恶性肿瘤。HER2阳性(HER2+)乳腺癌是一种分子亚型,其特点是病程具有侵袭性,肿瘤细胞有快速扩散的倾向,并且对标准的细胞抑制疗法有耐药性。许多大型随机试验表明,使用新辅助化疗提供了与辅助方案相同的总生存率。此外,新辅助化疗的使用使得治疗性病理形态的形成成为可能。由于与HER2蛋白的不同亚结构域相互作用,新的化疗药物的发现使得使用HER2受体的双重阻断成为可能。特别是,使用曲妥珠单抗、帕妥珠单抗和多西他赛的化疗已被证明是一种有效的方案,可以实现高的治疗性病理形态学和生存率。本文分析了曲妥珠单抗与帕妥珠单抗联合应用的作用机制及疗效,并介绍了两例应用双靶向阻断治疗的临床实例。
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