Neoadjuvant Trastuzumab Concurrent with Nonanthracycline-based Regimens for HER2-positive Locally Advanced Breast Cancer

賀癌平針對局部晚期乳癌的前導性治療

劉韋新(Wei-Hsin Liu) ； 劉美瑾(Mei-Ching Liu) ； 余本隆(Ben-Long Yu) ； 鄭鴻鈞(Skye Hung-Chun Cheng) ； 李明媛(Ming-Yuan Li) ； 鍾奇峰(Chi-Feng Chung) ； 王宗德(Tzung-De Wang) ； 洪啟峰(Chi-Feng Hung)

《台灣癌症醫學雜誌》 1卷2期 (2014/09) Pp. 163-171

https://doi.org/10.6323/JCRP.2014.1.2.11

摘要

賀癌平（Trastuzumab）是一種作用於人類表皮生長因子受體II（HER-2）的單株抗體。目前賀癌平已證實對於HER-2過度表現的乳癌有臨床上的效益。針對初期乳癌（第一期至第三期）術後的輔助性治療，賀癌平搭配化學治療為目前治療的準則。然而，針對局部晚期乳癌術前所給予的前導性治療，賀癌平所扮演的角色目前仍不確定。但有越來越多的文獻指出，賀癌平合併化學治療作為局部晚期乳癌的前導性治療有臨床上的助益。我們於此做一個個案報告，病患是一位47歲女性，診斷為HER-2陽性的局部晚期乳癌。病患接受化學治療合併賀癌平作為前導性治療，術後達病理性完全反應，且目前超過5年無疾病復發證據。最後，我們對於賀癌平在前導性治療所扮演的角色做了文獻回顧。

關鍵字

賀癌平 ； 局部晚期乳癌 ； 前導性治療 ； 病理性完全反應

並列摘要

Trastuzumab, a humanized monoclonal antibody directed against the external domain of the HER-2 protein, has shown remarkable activity against HER-2 positive breast cancer. Consequently, the use of adjuvant trastuzumab plus chemotherapy in patients with HER2-positive stage breast cancer (stage I to III) has become the standard treatment option. However, the role of trastuzumab in neoadjuvant treatment therapy is still uncertain. An increasing number of clinical trials and inadequate analysis show the benefit of adding trastuzumab to chemotherapy in the neoadjuvant setting. We report a case of HER2-positive locally advanced breast cancer in a patient who received cytotoxic agents concomitant with trastuzumab as neoadjuvant therapy, and also review the published literature. The patient achieved pathological complete response, and remained disease-free for more than 5 years.

並列關鍵字

trastuzumab ； locally advanced breast cancer ； neoadjuvant therapy ； pathologic complete response (pCR)