Systemic Therapy For Early-Stage HER2-Positive Breast Cancers: Time for a Less-Is-More Approach?

作者：Paplomata Elisavet; Nahta Rita; O'Regan Ruth M^*

来源：Cancer, 2015, 121(4): 517-526.

DOI：10.1002/cncr.29060

• human epidermal growth factor receptor 2 (HER2)
• breast cancer
• estrogen receptor
• stage I

Trastuzumab-based chemotherapy has dramatically improved outcomes for patients with all stages of human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Additional HER2-directed agents that have recently been approved are also expected to improve outcomes. Patients with small, lymph node-negative, HER2-positive breast cancers who are treated with trastuzumab-based chemotherapy demonstrate especially favorable responses, with 5-year recurrence rates of <5%. In this review, recent data regarding response rates among patients with early-stage HER2-positive breast cancer treated with trastuzumab-based chemotherapy are discussed. This review supports future studies of the possible omission of chemotherapy in a subset of patients with HER2-positive cancers, specifically those that coexpress hormone receptors. Cancer 2015;121:517-526. (c) 2014 American Cancer Society.
Patients with small human epidermal growth factor receptor 2 (HER2)-positive cancers have an excellent outcome when treated with trastuzumab-based chemotherapy, suggesting that less aggressive treatment approaches may be appropriate for some patients. HER2-positive cancers that coexpress hormone receptors are heterogenous, and a subset appear to be driven at least in part by estrogen receptor and may be optimally treated with coinhibition of estrogen receptor and HER2 rather than chemotherapy.

• 出版日期2015-2-15