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首页> 外文期刊>Advanced studies in medicine >Trastuzumab: Molecularly targeted therapy for early and metastatic HER-2eu-positive breast cancer
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Trastuzumab: Molecularly targeted therapy for early and metastatic HER-2eu-positive breast cancer

机译：曲妥珠单抗：早期和转移性HER-2 / neu阳性乳腺癌的分子靶向治疗

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PURPOSE: To review recent clinical trials that have evaluated the safely and efficacy of trastuzumab in the treatment of early and metastatic breast cancer overexpressing HER-2eu EPIDEMIOLOGY: Breast cancer affects more than 200 000 women in the United States each year, and accounts for an estimated 40 000 deaths annually. It is not a single entity, but a clinically diverse group of malignancies with varying natural histories and responses to therapy. Overexpression of the proto-oncogene HER-2eu defines a unique subset of breast cancers, is seen in 20% to 30% of breast tumors overall, and is associated with more aggressive disease and reduced survival time in node-positive and node-negative patients. REVIEW SUMMARY: HER-2eu is an attractive therapeutic target, particularly because its overexpression is essential for initiating and maintaining tumor growth and progression. Clinical trials have demonstrated that targeted therapy with the HER-2eu-specific monoclonal antibody trastuzumab, either alone or in combination with other cytotoxic agents, can produce durable objective responses, and increase time to disease progression and survival time in women with metastatic tumors that overexpress HER-2eu. More recent studies evaluating the drug with or following chemotherapy in women with early HER-2eu-positive breast cancer have shown that it also has a marked clinical benefit in this population, decreasing the risk of relapse by approximately 50%. This represents the largest degree of therapeutic benefit in early breast cancer reported since the introduction of tamoxifen for hormone receptor-positive disease approximately 25 years ago. TYPE OF AVAILABLE EVIDENCE: Meta-analyses, randomized trials, retrospective cohort studies, unstructured reviews, and conference proceedings/presentation slides. GRADE OF AVAILABLE EVIDENCE: Good, CONCLUSION: Trastuzumab reflects real progress in the treatment of HER-2eu-positive breast cancer and underscores the value of targeted therapy. Clinical trials have demonstrated that trastuzumab improves clinical outcomes and offers a survival benefit to patients with early or metastatic breast cancer overexpressing HER-2eu. Careful patient selection for HER-2eu overexpression is essential prior to therapy, as is frequent cardiac monitoring prior to and during therapy.
机译：目的：回顾最近的临床试验，该试验评估了曲妥珠单抗治疗过表达HER-2 / neu的早期和转移性乳腺癌的安全性和有效性流行病学：乳腺癌在美国每年影响超过20万名女性，并说明估计每年有4万人死亡。它不是单个实体，而是具有不同自然历史和对治疗反应的临床上多种多样的恶性肿瘤。原癌基因HER-2 / neu的过表达定义了乳腺癌的一个独特子集，在乳腺癌的整体发病率中占20％至30％，并且与更具侵略性的疾病以及在淋巴结阳性和淋巴结转移中的生存时间缩短有关阴性患者。综述：HER-2 / neu是一种有吸引力的治疗靶标，特别是因为它的过表达对于启动和维持肿瘤的生长和发展至关重要。临床试验表明，单独或与其他细胞毒性药物联合使用HER-2 / neu特异性单克隆抗体曲妥珠单抗进行靶向治疗可产生持久的客观反应，并增加转移性肿瘤女性的疾病进展时间和生存时间过度表达HER-2 / neu。较新的评估该药在早期HER-2 / neu阳性乳腺癌女性患者中进行化疗后的研究表明，该药物在该人群中也具有明显的临床益处，可将复发风险降低约50％。自从将他莫昔芬用于激素受体阳性疾病引入大约25年前以来，这代表了早期乳腺癌中最大的治疗益处。可用证据的类型：荟萃分析，随机试验，回顾性队列研究，非结构化评论以及会议记录/演示幻灯片。可用证据的程度：良好，结论：曲妥珠单抗反映了HER-2 / neu阳性乳腺癌治疗的真正进展，并强调了靶向治疗的价值。临床试验表明曲妥珠单抗可改善临床结局并为过表达HER-2 / neu的早期或转移性乳腺癌患者提供生存益处。对于HER-2 / neu过表达，要在治疗之前仔细选择患者，在治疗之前和治疗过程中要经常进行心脏监测。

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