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Current neoadjuvant treatment options for HER2-positive breast cancer

Approximately one quarter of patients with breast cancer demonstrate amplification of the human epidermal receptor type 2 (HER2) gene, the expression of which is associated with a relatively poor prognosis independent of other clinical and pathologic variables. Trastuzumab, a humanized recombinant m...

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Autores principales: Abdel-Razeq, Hikmat, Marei, Lina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156251/
https://www.ncbi.nlm.nih.gov/pubmed/21847344
http://dx.doi.org/10.2147/BTT.S22917
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author Abdel-Razeq, Hikmat
Marei, Lina
author_facet Abdel-Razeq, Hikmat
Marei, Lina
author_sort Abdel-Razeq, Hikmat
collection PubMed
description Approximately one quarter of patients with breast cancer demonstrate amplification of the human epidermal receptor type 2 (HER2) gene, the expression of which is associated with a relatively poor prognosis independent of other clinical and pathologic variables. Trastuzumab, a humanized recombinant monoclonal antibody specifically directed against the HER2 receptor, has been shown to be biologically active and of considerable clinical utility in HER2-positive breast cancer patients. Neoadjuvant chemotherapy has been used in breast cancer to downstage the tumor and increase the opportunity for breast-conserving surgery. Preoperative chemotherapy can also serve as an in vivo testing of chemotherapy sensitivity. Additionally, a pathologic complete response is usually a surrogate marker of disease-free survival. Following the successful use of trastuzumab in the metastatic and adjuvant settings, many clinical trials have recently reported the successful use of anti-HER2 therapy in combination with different chemotherapy regimens in the neoadjuvant setting with a significantly higher pathologic complete response. With the recent introduction of new anti-HER2 drugs, interest has shifted toward dual HER2 blockade. Two such studies were recently reported, both showing a significant advantage of dual anti-HER2 therapy using lapatinib or pertuzumab in addition to trastuzumab and chemotherapy. However, several key questions need to be investigated further, such as the preferred combination chemotherapy and the optimal duration of trastuzumab in patients who achieve a pathologic complete response following preoperative chemotherapy with trastuzumab. These issues and others are discussed in this review.
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spelling pubmed-31562512011-08-16 Current neoadjuvant treatment options for HER2-positive breast cancer Abdel-Razeq, Hikmat Marei, Lina Biologics Review Approximately one quarter of patients with breast cancer demonstrate amplification of the human epidermal receptor type 2 (HER2) gene, the expression of which is associated with a relatively poor prognosis independent of other clinical and pathologic variables. Trastuzumab, a humanized recombinant monoclonal antibody specifically directed against the HER2 receptor, has been shown to be biologically active and of considerable clinical utility in HER2-positive breast cancer patients. Neoadjuvant chemotherapy has been used in breast cancer to downstage the tumor and increase the opportunity for breast-conserving surgery. Preoperative chemotherapy can also serve as an in vivo testing of chemotherapy sensitivity. Additionally, a pathologic complete response is usually a surrogate marker of disease-free survival. Following the successful use of trastuzumab in the metastatic and adjuvant settings, many clinical trials have recently reported the successful use of anti-HER2 therapy in combination with different chemotherapy regimens in the neoadjuvant setting with a significantly higher pathologic complete response. With the recent introduction of new anti-HER2 drugs, interest has shifted toward dual HER2 blockade. Two such studies were recently reported, both showing a significant advantage of dual anti-HER2 therapy using lapatinib or pertuzumab in addition to trastuzumab and chemotherapy. However, several key questions need to be investigated further, such as the preferred combination chemotherapy and the optimal duration of trastuzumab in patients who achieve a pathologic complete response following preoperative chemotherapy with trastuzumab. These issues and others are discussed in this review. Dove Medical Press 2011 2011-08-09 /pmc/articles/PMC3156251/ /pubmed/21847344 http://dx.doi.org/10.2147/BTT.S22917 Text en © 2011 Abdel-Razeq and Marei, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Review
Abdel-Razeq, Hikmat
Marei, Lina
Current neoadjuvant treatment options for HER2-positive breast cancer
title Current neoadjuvant treatment options for HER2-positive breast cancer
title_full Current neoadjuvant treatment options for HER2-positive breast cancer
title_fullStr Current neoadjuvant treatment options for HER2-positive breast cancer
title_full_unstemmed Current neoadjuvant treatment options for HER2-positive breast cancer
title_short Current neoadjuvant treatment options for HER2-positive breast cancer
title_sort current neoadjuvant treatment options for her2-positive breast cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156251/
https://www.ncbi.nlm.nih.gov/pubmed/21847344
http://dx.doi.org/10.2147/BTT.S22917
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