Further progress in HER2-directed therapy.

摘要

Outcomes for women with early stage HER2-positive breast cancer have improved markedly since the introduction of the HER2-targeted monoclonal antibody trastuzumab. Women with node-positive disease can expect relapse-free survival to exceed 80% when treated with multi-agent chemotherapy and trastuzumab. However, there is still room for improvement, both by further reducing recurrence rates and by decreasing the toxicities of treatment. For some patients, the option may ultimately existto eliminate chemotherapy entirely. One potential approach to optimising HER2-directed therapy is to combine two HER2-targeted agents with non-overlapping mechanisms of action. Such an approach wastested in the NeoSphere study described by Gianni and colleagues in The Lancet Oncology. This trial assessed the efficacy of 12 weeks of preoperative docetaxel combined with either of two HER2-directed monoclonal antibodies, pertuzumab, trastuzumab, or the two together in women with HER2-positive early stage breast cancer. Patients in a fourth arm of the study received the two antibodies without chemotherapy.