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1、HER2阳性EBC的应对策略AdjuvantCMF21%RiskofrecurrenceBonadonnaetal.BMJ2005;330:2171976TheCMFprogrammeCMFvsobservationC,cyclophosphamide;M,methotrexate;F,5-fluorouracilFirstpublication:Bonadonnaetal.NEnglJMed1976;294:405-410Latestdata29%Riskofdeath1976Adjuvanttamoxifen36%
2、29%RiskofrecurrenceRiskofdeathFirstpublication:Lancet1983;1:257-261BrJCancer1988;57:608-611Latestdata1983NATOtrialTamoxifenvsobservationAdjuvantanthracyclinesRiskofrecurrenceFirstpublication:Levineetal.JClinOncol1998;16:2651-2658LatestdataLevineetal.JClinOncol20
3、05;23:5166-51701998NCICMA.5CEFvsCMF24%C,cyclophosphamide; E,epirubicin;F,fluorouracil; M,methotrexateAdjuvanttaxanes18%RiskofrecurrenceRiskofdeath1998Firstpublication:Hendersonetal.ProcAmSocClinOncol1998;17:101a,abs390ACALGB9344AC→PvsAC17%A,doxorubicin;C,cycloph
4、osphamide;P,paclitaxelLatestdataHendersonetal.JClinOncol2003;21:976-983Adjuvantaromataseinhibitors13%RiskofrecurrenceFirstpublication:Baumetal.BreastCancerResTreat2001;69:210,abs82001ATACAnastrozolevstamoxifenHowelletal.Lancet2005;365:60-62LatestdataAdjuvantHerc
5、eptin36%34%RiskofrecurrenceRiskofdeathFirstpresentation:Piccart-Gebhartetal.ASCO2005Smithetal.Lancet2007;369:29-36Latestdata3furtherlargestudieshavealsodemonstratedsimilarsignificantreductionsinriskofrelapseandriskofdeathRomondetal.NEnglJMed2005;353:1673-1684;Sl
6、amonetal.SABCS2006;abs522005HERA1-yearHerceptinvsobservationafterchemotherapyHER2:roleinbreastcancerHumanepidermalgrowthfactorreceptor2(HER2)isatransmembraneproteinandpartoftheHERfamilyof 4growthfactorreceptors(HER1toHER4)1OverexpressionofHER2and/oramplification
7、ofthe HER2geneoccursinupto30%ofbreastcancers1-3HER2positivityisassociatedwith2-4aggressivediseaseahighriskofrelapsepoorsurvivalHER2istheonlymemberoftheHERfamilyacknowledged inguidelinesforitsprognosticandpredictivevaluein breastcancer5HER2isanimportanttherapeuti
8、ctargetSlamonDJ,etal.Science1989;244:707–712SlamonDJ,etal.Science1987;235:177–182Penault-LlorcaF,etal.JClinOncol(MeetingAbstracts)2005;23:69s,abs764PressMF,etal.JClin
