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Systemic treatment of HER2+ breast cancer patients. Part 1

Sylwia Dębska

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2011, 9 (4), p. 227-237
Streszczenie

In Poland, morbidity associated with breast cancer has been increasing over the past 40 years. Current advances in our understanding of breast cancer biology preclude considering this condition as a homogenous nosologic entity. Several subtypes of breast cancer: luminal A (ER+, PR+, HER2-), luminal B (ER+, PR+, HER2+), HER2-dependent (ER-, PR-, HER2+) and the so-called triple-negative or basic (ER-, PR-, HER2-) differ in clinical course and prognosis and require an individualized therapeutic approach. HER2 receptor is one of a family of human growth factor receptors. It may become expressed in different tissues, participating in growth and differentiation of cells. HER2 overexpression in breast cancer cells correlates with worse prognosis, but also enables implementation of targeted, anti-HER2 molecular therapies. As estimated, about 25% of breast tumors are HER2-positive and in these patients the use of “targeted” therapy should be considered. Therefore, at present, standard histological study of breast cancer should include immunohistochemical assessment of HER2 receptor expression. Patients with equivocal result of the IHC study (HER2 2+) require quantitative analysis of HER2 gene copies in cancer cells using the FISH technique. Only patients with HER2 receptor overexpression (HER2 3+) or HER2 gene amplification are candidates for targeted molecular treatment. The first drug of this kind is monoclonal antibody trastuzumab, binding with the HER2 receptor and blocking HER2-dependent intracellular processes, while triggering a cytotoxic cellular antibody-dependent immune reaction directed against cancer cells.

Słowa kluczowe
HER receptor family, HER2 overexpression, HER2 gene amplification, prognostic factors in breast cancer, trastuzumab, antibody-dependent cellular cytotoxic reaction