Background: The overexpression of the human epidermal growth factor receptor 2 (HER2+) accounts for 15–20% of all breast cancer phenotypes. Even after the completion of the standard combination of chemotherapy and trastuzumab, relapse events occur in approximately 15% of cases. The neoadjuvant approach has multiple benefits that include the potential to downgrade staging and convert previously unresectable tumors to operable tumors. In addition, achieving a pathologic complete response (pCR) following preoperative systemic treatment is prognostic of enhanced survival outcomes. Thus, optimal evaluation among the suitable strategies is crucial in deciding which patients should be selected for the neoadjuvant approach. Methods: A literature search was conducted in the Embase, Medline, and Cochrane electronic libraries. Conclusion: The evaluation of tumor and LN staging and, hence, stratifying BC recurrence risk are decisive factors in guiding clinicians to optimize treatment decisions between the neoadjuvant versus adjuvant approaches. For each individual case, it is important to consider the most likely postsurgical outcome, since, if the patient does not obtain pCR following neoadjuvant treatment, they are eligible for adjuvant T-DM1 in the case of residual disease. This review of HER2-positive female BC outlines suitable neoadjuvant and adjuvant systemic treatment strategies for guiding clinical decision making around the selection of an appropriate therapy.
背景：人表皮生长因子受体2（HER2+）过表达约占所有乳腺癌表型的15%至20%。即使在完成化疗与曲妥珠单抗的标准联合治疗后，仍有约15%的病例出现复发事件。新辅助治疗具有多重优势，包括可能降低肿瘤分期，并将原本不可切除的肿瘤转化为可手术切除的肿瘤。此外，术前系统治疗后达到病理完全缓解（pCR）预示着更好的生存结局。因此，在合适的策略中进行最佳评估对于决定哪些患者应选择新辅助治疗至关重要。 方法：在Embase、Medline和Cochrane电子数据库中进行文献检索。 结论：评估肿瘤及淋巴结分期，进而对乳腺癌复发风险进行分层，是指导临床医生优化新辅助与辅助治疗决策的关键因素。对于每个病例，考虑最可能的手术结果至关重要，因为如果患者在新辅助治疗后未达到pCR，在存在残留病灶的情况下，他们将有资格接受辅助T-DM1治疗。本综述针对HER2阳性女性乳腺癌，概述了合适的新辅助和辅助系统治疗策略，以指导临床决策，选择恰当的治疗方案。
Appraisal of Systemic Treatment Strategies in Early HER2-Positive Breast Cancer—A Literature Review
肿瘤(癌症)患者之家