曲妥珠单抗在HER-2阳性乳腺癌患者新辅助治疗中的应用研究进展

曲妥珠单抗是人表皮生长因子受体-2（human epidermal growth factor receptor-2，HER-2）的特异性抑制剂，在HER-2阳性乳腺癌患者新辅助治疗中的应用日益广泛。大规模的随机、对照临床试验证实，新辅助化疗联合曲妥珠单抗与单纯化疗比较能显著提高病理完全缓解（pathologic complete response，pCR）率。在曲妥珠单抗联合化疗的基础上加用拉帕替尼较单用曲妥珠单抗可大大提高pCR率。蒽环与非蒽环类化疗药物均可作为曲妥珠单抗的联合用药，内分泌治疗也可作为雌激素受体阳性患者的联合用药。pCR是曲妥珠单抗新辅助治疗后生存获益的独立预后因素，HER-2转阴而未达到pCR的患者为不良预后因素。本文将对曲妥珠单抗在HER-2阳性乳腺癌患者新辅助治疗中的研究进展进行综述。 

Advanced research on neoadjuvant therapy with trastuzumab in HER2-positive breast cancer

Trastuzumab is a specific inhibitor against human epidermal growth factor receptor-2 (HER-2). Trastuzumab is widely used in the neo-adjuvant treatment of HER-2 breast cancer. Large-scale randomized and controlled clinical trials have demonstrated that pathologic complete response rates (pCRs) were significantly increased with neo-adjuvant trastuzumab therapy plus chemotherapy than with regular chemotherapy. The use of trastuzumab plus chemotherapy with lapatinib supplements could further improve pCR rates. Anthracycline and non-anthracycline drugs could both be used concurrently with trastuzumab. Endocrine therapy could be used as an alternative for estrogen receptor-positive patients. pCR is a powerful predictor of long-term outcomes in HER-2 positive patients under neo-adjuvant therapy with trastuzumab. However, patient loss of HER-2 expression with residual disease after neo-adjuvant therapy with trastuzumab is a poor prognostic factor. This study paper will provide a review of related research.