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Role of HER2-Targeted Agents in Adjuvant Treatment for Breast Cancer

机译：HER2靶向药物在乳腺癌辅助治疗中的作用

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Approximately 20% of breast cancers overexpress human epidermal growth factor receptor 2 (HER2) protein, mainly as a result of gene amplification. The receptor tyrosine kinase is believed to play a critical role in the pathogenesis and further proliferation of these tumors. The application of trastuzumab, a humanized monoclonal antibody against the extracellular domain of HER2 protein, to HER2-positive metastatic breast cancer has significantly improved treatment outcomes. Following this success, several phase III trials have evaluated the role of trastuzumab in the adjuvant setting, with the result that trastuzumab use is now the standard of care for most HER2-positive early breast cancer patients. In this paper, we review these pivotal phase III trials. We also discuss unresolved issues in adjuvant treatment with trastuzumab, including target patient population, sequential or concurrent use with chemotherapy or radiation, treatment duration, cardiotoxicity, and the possibility of eliminating chemotherapy. Following confirmation of its ability to partially overcome trastuzumab resistance, we also discuss the role of lapatinib in adjuvant use.
机译：主要由于基因扩增，大约20％的乳腺癌过表达人类表皮生长因子受体2（HER2）蛋白。受体酪氨酸激酶被认为在这些肿瘤的发病机理和进一步增殖中起关键作用。曲妥珠单抗（一种针对HER2蛋白胞外域的人源化单克隆抗体）在HER2阳性转移性乳腺癌中的应用显着改善了治疗效果。获得成功之后，几项III期临床试验评估了曲妥珠单抗在佐剂中的作用，结果表明曲妥珠单抗的使用现已成为大多数HER2阳性早期乳腺癌患者的治疗标准。在本文中，我们回顾了这些关键的III期临床试验。我们还讨论了曲妥珠单抗辅助治疗中未解决的问题，包括目标患者人群，化学疗法或放射疗法的顺序或同时使用，治疗时间，心脏毒性以及消除化学疗法的可能性。在确认其部分克服曲妥珠单抗耐药性的能力后，我们还讨论了拉帕替尼在佐剂使用中的作用。

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