|
|
HER2阳性晚期乳腺癌一线治疗的共识和争议
|
Abstract:
人表皮生长因子受体-2 (HER2)扩增是HER2阳性乳腺癌的侵袭性高、预后差的重要因素。抗HER2靶向药物的出现明显提高了患者的生存期，极大改善了预后。目前HER2阳性晚期乳腺癌一线治疗的标准治疗方案为曲妥珠单抗联合帕妥珠单抗和化疗，然而，仍有临床问题存在争议，包括HER2阳性晚期乳腺癌晚期一线选择帕妥珠单抗还是酪氨酸激酶抑制剂，既往接受曲妥珠单抗治疗患者该如何选择，HER2阳性脑转移患者靶向治疗的对比，激素受体阳性HER2阳性病人内分泌治疗和化疗该如何取舍，目前新的药物和联合治疗的进展。我们对此进行综述，以期为HER2阳性晚期乳腺癌的临床治疗提供参考。
The amplification of human epidermal growth factor receptor-2 (HER2) is an important factor in the high invasiveness and poor prognosis of HER2 positive breast cancer. The emergence of anti-HER2 targeting drugs significantly increased the survival time of patients and greatly improved the prognosis. At present, the standard first-line treatment for HER2-positive advanced breast cancer is trastuzumab combined with patuzumab and chemotherapy. However, there are still some clinical issues in dispute, including the choice of first-line HER2-positive breast cancer with patuzumab or TKI, the optimal regimen for patients who have previously received trastuzumab, and the comparison of targeted therapy for patients with HER2-positive brain metastasis. How to choose between endocrine therapy and chemotherapy in hormone receptor positive HER2 positive patients? We review the progress of new drugs and combined therapy, in order to provide reference for the clinical treatment of HER2 positive advanced breast cancer.
| [1] | Loibl, S., Poortmans, P., Morrow, M., Denkert, C. and Curigliano, G. (2021) Breast Cancer. The Lancet, 397, 1750-1769. https://doi.org/10.1016/s0140-6736(20)32381-3 |
| [2] | Li, J., Shao, Z., Xu, B., Jiang, Z., Cui, S., Zhang, J., et al. (2018) Use of Trastuzumab as an Adjuvant/Neoadjuvant Therapy in Patients with HER2-Positive Breast Cancer in China. Medicine, 97, e10350. https://doi.org/10.1097/md.0000000000010350 |
| [3] | Xu, B., Li, W., Zhang, Q., Li, Q., Wang, X., Li, H., et al. (2022) Pertuzumab, Trastuzumab, and Docetaxel for Chinese Patients with Previously Untreated HER2-Positive Locally Recurrent or Metastatic Breast Cancer (PUFFIN): Final Analysis of a Phase III, Randomized, Double-Blind, Placebo-Controlled Study. Breast Cancer Research and Treatment, 197, 503-513. https://doi.org/10.1007/s10549-022-06775-1 |
| [4] | Ma, F., Yan, M., Li, W., Ouyang, Q., Tong, Z., Teng, Y., et al. (2023) Pyrotinib versus Placebo in Combination with Trastuzumab and Docetaxel as First Line Treatment in Patients with HER2 Positive Metastatic Breast Cancer (PHILA): Randomised, Double Blind, Multicentre, Phase 3 Trial. BMJ, 383, e076065. https://doi.org/10.1136/bmj-2023-076065 |
| [5] | Wang, B., You, S., Xie, Y., et al. (2023) 427P Pyrotinib Plus Trastuzumab versus Pertuzumab Plus Trastuzumab in Patients with HER2-Positive Metastatic Breast Cancer: A Multicenter, Retrospective Study. Annals of Oncology, 34, S361-S362. https://doi.org/10.1016/j.annonc.2023.09.603 |
| [6] | Miles, D., Ciruelos, E., Schneeweiss, A., Puglisi, F., Peretz-Yablonski, T., Campone, M., et al. (2021) Final Results from the Peruse Study of First-Line Pertuzumab Plus Trastuzumab Plus a Taxane for HER2-Positive Locally Recurrent or Metastatic Breast Cancer, with a Multivariable Approach to Guide Prognostication. Annals of Oncology, 32, 1245-1255. https://doi.org/10.1016/j.annonc.2021.06.024 |
| [7] | Zheng, Y., Cao, W., Shao, X., Shi, Y., Cai, L., Chen, W., et al. (2023) Pyrotinib Plus Docetaxel as First-Line Treatment for HER2-Positive Metastatic Breast Cancer: The PANDORA Phase II Trial. Nature Communications, 14, Article No. 8314. https://doi.org/10.1038/s41467-023-44140-y |
| [8] | Nader-Marta, G., Martins-Branco, D. and de Azambuja, E. (2022) How We Treat Patients with Metastatic HER2-Positive Breast Cancer. ESMO Open, 7, 100343. https://doi.org/10.1016/j.esmoop.2021.100343 |
| [9] | Lin, N.U., Murthy, R.K., Abramson, V., Anders, C., Bachelot, T., Bedard, P.L., et al. (2023) Tucatinib vs Placebo, Both in Combination with Trastuzumab and Capecitabine, for Previously Treated ERBB2 (HER2)-Positive Metastatic Breast Cancer in Patients with Brain Metastases. JAMA Oncology, 9, 197-205. https://doi.org/10.1001/jamaoncol.2022.5610 |
| [10] | Yan, M., Bian, L., Hu, X., Zhang, Q., Ouyang, Q., Feng, J., et al. (2020) Pyrotinib Plus Capecitabine for Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer After Trastuzumab and Taxanes (PHENIX): A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study. Translational Breast Cancer Research, 1, 13. https://doi.org/10.21037/tbcr-20-25 |
| [11] | Yan, M., Ouyang, Q., Sun, T., Niu, L., Yang, J., Li, L., et al. (2021) Pyrotinib Plus Capecitabine for HER2-Positive Metastatic Breast Cancer Patients with Brain Metastases (PERMEATE): A Multicenter, Single-Arm Phase II Study. Journal of Clinical Oncology, 39, 1037-1037. https://doi.org/10.1200/jco.2021.39.15_suppl.1037 |
| [12] | Hua, X., Bi, X., Zhao, J., Shi, Y., Lin, Y., Wu, Z., et al. (2021) Trastuzumab Plus Endocrine Therapy or Chemotherapy as First-Line Treatment for Patients with Hormone Receptor-Positive and HER2-Positive Metastatic Breast Cancer (SYSUCC-002). Clinical Cancer Research, 28, 637-645. https://doi.org/10.1158/1078-0432.ccr-21-3435 |
| [13] | Arpino, G., de la Haba Rodríguez, J., Ferrero, J., De Placido, S., Osborne, C.K., et al. (2023) Pertuzumab, Trastuzumab, and an Aromatase Inhibitor for HER2-Positive and Hormone Receptor-Positive Metastatic or Locally Advanced Breast Cancer: PERTAIN Final Analysis. Clinical Cancer Research, 29, 1468-1476. https://doi.org/10.1158/1078-0432.ccr-22-1092 |
| [14] | Tolaney, S.M., Barroso-Sousa, R., Jiang, Z., Park, Y.H., Rimawi, M., Saura Manich, C., et al. (2021) 328TiP Phase III Study of Trastuzumab Deruxtecan (T-DXd) with or Without Pertuzumab vs a Taxane, Trastuzumab and Pertuzumab in First-Line (1L), Human Epidermal Growth Factor Receptor 2-positive (HER2 ) Metastatic Breast Cancer (mBC): DESTINY-Breast09. Annals of Oncology, 32, S507-S508. https://doi.org/10.1016/j.annonc.2021.08.611 |
| [15] | Kulukian, A., Lee, P., Taylor, J., Rosler, R., de Vries, P., Watson, D., et al. (2020) Preclinical Activity of HER2-Selective Tyrosine Kinase Inhibitor Tucatinib as a Single Agent or in Combination with Trastuzumab or Docetaxel in Solid Tumor Models. Molecular Cancer Therapeutics, 19, 976-987. https://doi.org/10.1158/1535-7163.mct-19-0873 |
| [16] | Hamilton, E.P., Martin, M., O’Sullivan, C.C., Curigliano, G., Sohn, J., Tsurutani, J., et al. (2023) HER2CLIMB-05: Phase 3 Study of Tucatinib or Placebo in Combination with Trastuzumab and Pertuzumab as Maintenance Therapy for HER2 Metastatic Breast Cancer. Journal of Clinical Oncology, 41, TPS1115-TPS1115. https://doi.org/10.1200/jco.2023.41.16_suppl.tps1115 |
| [17] | Wei, H., Cai, H., Jin, Y., Wang, P., Zhang, Q., Lin, Y., et al. (2017) Structural Basis of a Novel Heterodimeric Fc for Bispecific Antibody Production. Oncotarget, 8, 51037-51049. https://doi.org/10.18632/oncotarget.17558 |
| [18] | Park, Y.H., Ahn, H.K., Kim, J., Ahn, J.S., Im, Y., Kim, S., et al. (2020) First-in-Human Phase I Study of ALT-P7, a HER2-Targeting Antibody-Drug Conjugate in Patients with HER2-Positive Advanced Breast Cancer. Journal of Clinical Oncology, 38, 3551-3551. https://doi.org/10.1200/jco.2020.38.15_suppl.3551 |
| [19] | Emens, L.A., Esteva, F.J., Beresford, M., Saura, C., De Laurentiis, M., Kim, S., et al. (2020) Trastuzumab Emtansine plus Atezolizumab versus Trastuzumab Emtansine Plus Placebo in Previously Treated, HER2-Positive Advanced Breast Cancer (KATE2): A Phase 2, Multicentre, Randomised, Double-Blind Trial. The Lancet Oncology, 21, 1283-1295. https://doi.org/10.1016/s1470-2045(20)30465-4 |
