The more she talks about her family. Professor Song Guohong and Professor Liu Jun: The Redemption of QutoZhu Monotum.

*Trastuzumab mentioned in the article refers to the "Herceptin" film "Shawshank Redemption", which tells a story about hope and freedom.Andy was wrongly jailed, but he still had a desire for freedom in his heart. With super tenacity and perseverance, he dug the wall silently with a small hammer for 19 years, and finally escaped from prison successfully.breast cancer patients, once diagnosed, are like entering Shawshank prison and facing life imprisonment.is there a "small hammer" that can help breast cancer patients to open a tunnel of hope and get reborn? Yimaitong had the honor to invite Professor Song Guohong of Peking University Cancer Hospital and Professor Liu Jun of Tianjin Cancer Hospital to share the "rescue of HER2 positive breast cancer by trastuzumab".introduction of Professor Song Guohong, Department of breast cancer, Peking University Cancer Hospital The chief physician presides over the National Natural Science Foundation of China and the fund for overseas students. Chairman of the professional committee of breast cancer precise targeted diagnosis and treatment of Beijing Cancer Prevention and control society, standing member of breast disease research center of Chinese Women Doctors Association, standing member of Internal Medicine Professional Committee of Beijing breast disease prevention and control society, standing member of Health Management Professional Committee of Beijing breast disease prevention and control society, China Medical Education Association Member of the Standing Committee of breast diseases, standing committee member and Deputy Secretary General of breast disease branch of China Association for international exchange and promotion of medical care Deputy chief physician has been engaged in the diagnosis, comprehensive treatment, surgery and plastic surgery and research of breast cancer for 20 years. Yimaitong: in patients with breast cancer, HER2 positive is a relatively dangerous subtype with poor prognosis.the launch of trastuzumab has opened a tunnel to freedom and hope for such patients. How do you evaluate the status of trastuzumab in HER2 positive breast cancer patients? Professor Song Guohong: HER2 positive breast cancer is a subtype of breast cancer with high malignancy and poor prognosis. It is easy to have early recurrence and metastasis, and the survival period of patients is short.at the same time, HER2 is also a predictor of curative effect. Patients with HER2 positive breast cancer can benefit from targeted anti HER2 therapy.the launch of trastuzumab (Herceptin) has brought great hope to HER2 positive breast cancer patients. Just like the "little hammer" in the film, it has opened a tunnel to hope.trastuzumab based regimens have changed the therapeutic pattern of HER2 positive breast cancer and are in a cornerstone position in neoadjuvant therapy, adjuvant therapy and advanced breast cancer treatment.in the neoadjuvant therapy of HER2 positive breast cancer, the combination of chemotherapy and trastuzumab targeting therapy can significantly improve the PCR rate.as in the classic Noah study [1], the PCR rate can be increased from 22% to 43%.the clinical evidence of adjuvant therapy is more abundant. A series of research results such as Hera [2] and bcirg-006 [3] show that the combination of trastuzumab and chemotherapy can significantly improve DFS, and the DFS can reach 70% - 75% in 10 years.10 years of DFS is the clinical cure defined by who.therefore, for HER2 positive early breast cancer, through chemotherapy combined with trastuzumab adjuvant therapy, about 70% - 75% of patients can achieve clinical cure, which is a very good result.similarly, trastuzumab significantly improved the survival of HER2 positive advanced breast cancer patients.in the classic M77001 study [4], combined with trastuzumab targeted therapy on the basis of chemotherapy, can prolong the disease progression time (TTP) of HER2 positive advanced breast cancer patients from 6.1 months to 11.7 months, and the overall survival period from 22.7 months to 31.2 months.therefore, trastuzumab can significantly improve the prognosis and prolong the overall survival of HER2 positive breast cancer, whether it is early neoadjuvant or adjuvant therapy, or late treatment. the patients with HER2 positive breast cancer are very lucky. With trastuzumab as a powerful "weapon", HER2 positive breast cancer has changed from a highly malignant breast cancer with poor prognosis to a promising breast cancer with better prognosis. yimaitong: with the development and progress of modern medicine, we have more and more "weapons". trastuzumab and patuzumab combined with "HEPA double target" scheme for HER2 positive breast cancer patients to strive for greater benefits and longer survival, please talk about the benefits of this innovative treatment scheme for patients? Prof. song Guohong: 70% - 75% of patients with HER2 positive breast cancer can be clinically cured by trastuzumab single target adjuvant therapy. that is to say, there are still about 25% of patients with recurrence and metastasis, especially those with positive lymph nodes. so we need not only trastuzumab as a "small hammer", but also a stronger "weapon" to help patients achieve the goal of healing and improving prognosis. therefore, patuzumab came into being, and HEPA double target regimen can further improve the benefit of patients. in terms of the mechanism of action, trastuzumab and patuzumab combine with different regions of HER2, inhibit the formation of homodimer and heterodimer, and have complementary effects. at the same time, the two drugs have antibody dependent cell-mediated cytotoxicity (ADCC). At the same time, ADCC effect is superimposed to play a synergistic role to enhance the efficacy. in clinical studies, HEPA double target regimen has also achieved very good results. in neoadjuvant therapy, the PCR rate of HEPA double target was significantly higher than that of single target. in the neosphere study [5], the PCR rate of double target combination chemotherapy of HEPA was about twice that of single target regimen. therefore, it is recommended to use HEPA dual target chemotherapy for the neoadjuvant treatment of HER2 positive breast cancer. in the adjuvant therapy, HEPA double target regimen has also achieved significant curative effect. the study of apinity [6] on the basis of chemotherapy combined with double target therapy, compared with single target treatment, DFS was significantly improved, and the 6-year DFS rate was as high as 90.6%, especially for patients with positive lymph nodes. similarly, for HER2 positive advanced breast cancer, HEPA dual target therapy has also achieved remarkable results. in the classic Cleopatra study [7], on the basis of trastuzumab + chemotherapy, combined with patuzumab dual target therapy, not only prolonged PFS from 12.4 months to 18.7 months, but also extended the overall survival period from 40.8 months to 57.1 months, nearly 5 years. the overall survival of HER2 positive patients with advanced breast cancer can reach nearly 5 years, which is unimaginable in the past. therefore, for HER2 positive breast cancer, whether early neoadjuvant or adjuvant therapy, or late treatment, HEPA dual target regimen can further improve the efficacy and prolong the survival of patients. with more and more "weapons" in our hands, the patients have a greater chance of clinical cure. yimaitong: Herceptin, as the original trastuzumab, has experienced many battles from research and development to marketing, and has become the standard treatment drug for HER2 positive breast cancer. What's unique about Herceptin? Prof. Liu Jun: Herceptin is a kind of monoclonal antibody and macromolecular biological preparation. It has complex internal structure, high requirements of production process and complex process. It is a drug that is difficult to replicate. therefore, since the advent of Herceptin, Herceptin is still a leading edge in the treatment of HER2 positive breast cancer, and has become the standard treatment drug recommended by NCCN, ESMO, CSCO, CBCS and other authoritative guidelines. in clinical practice, Herceptin has sufficient evidence-based evidence. After 784 clinical trials and practice verification, Herceptin has brought about clinical benefits to 300000 Chinese breast cancer patients. at present, patuzumab has also been listed in China. HEPA double target regimen has further improved the cure rate of HER2 positive breast cancer, with a 5-year overall survival rate of 94.8%. it can be said that Herceptin is the "small hammer" in Andy's hands, which brings the dawn of cure for the majority of HER2 positive breast cancer patients. yimaitong: with the development of new drugs, more and more HER2 positive breast cancer drugs can be selected. There are not only original research drugs, but also biological analogues and non comparable biological drugs. As a clinical expert, what are your suggestions for drug selection? Professor Liu Jun: at present, the development of therapeutic drugs for HER2 positive breast cancer has brought good news to HER2 positive breast cancer patients. in terms of drug selection, the first thing to pay attention to is the efficacy and safety, and other factors (such as price) also need to be considered. the research and development process of the original drug can be described as a sword in ten years. From preclinical research (3-6 years) to phase I - IV clinical trials (6-7 years), thousands or even tens of thousands of patients have investigated the efficacy and safety of the drug before it can be approved for marketing. both biological analogues and non comparable biopharmaceuticals belong to generic drugs. Trastuzumab is a kind of monoclonal antibody with macromolecules. Strict procedures are required in the process of imitation, including drug analysis, preclinical research, clinical pharmacology research and clinical trial, which is more rigorous and cumbersome than the development process of common drugs. biological analogues and non comparable biological drugs are similar to the original drug in molecular structure, but due to their limited pharmaceutical analysis and clinical data, their indications can not reach the same level as the original drug. in the process of patients' treatment, clinicians will provide analysis and suggestions for patients to choose drugs, but the right of choice lies with the patients. in a word, with the progress of biotechnology, more and more drugs will continue to appear to benefit every patient. < br / < br / < br / < br / < br / < br / < br / < br / < br / < br / < br / < br / < br / < br / 1. Giannil L, et al. Lancet.2010; 375 (9712): 377-384.2. Cameron D, et al. Alcet et al. SABCS 2015.4. Marty m, et al. J Clin Oncol 2005; 23 (19): 4265-4274.5. Giannil L, lancet Oncol. 2012 Jan; 13 (1): 25 (1): 25-32.6. Piccart m, et al. 2019. Sassaccas sasassassa, 2013; 13 (1): 25 (1): 25-32.6. Piccart m, et al. 2019. Sassassassassassassasbcs. Gs1-04.7. Swain SM, et al. ASCO 2019, abstract 1020.