Yan Ying: Advanced breast cancer anti-HER2 reasonable stratization treatment.

Anti-HER2 targeted therapy drug stratification Anti-HER2 targeted therapy drugs can be divided into two categories according to the mechanism of drug action: one is monoclonal antibody class, including curto bead monoanti, patojutamol, T-DM1 and DS-8201, and so on;
CSCO BC anti-HER2 treatment concept: strated management patients can be divided into two categories, one is also suitable for antibody drug treatment patients; These include curvature, patojutamol, T-DM1 and DS-8201, and other small molecules of tyrosine kinase inhibitors, including Rapatinib, pyridoxine, nairatinib, which will be available this year, and Tucateni, which is already available abroad.
CSCO BC anti-HER2 therapy concept: strated management patients can be divided into two categories, one is also suitable for antibody drug treatment patients;
when we receive a HER2-positive patient with advanced breast cancer, we may encounter patients with these three conditions.
In the first case, the patient is in the initial treatment IV phase, or in the auxiliary treatment stage, without any antibody-type drugs auxiliary treatment;
in clinical practice, patients who have not used antibody therapy drugs, or who have stopped antibody therapy drugs, and who have relapsed metastasis after one year, still meet the principle of re-use of antibody drugs.
Based on the results of the CLEOPATRA study, the CSCO BC guidelines state that in patients who have not used antibody drugs or who meet the principles of re-use of antibody drugs, Class I recommends quercetojumocytosis and patojumodythroposis and yew chemotherapy.
but there is a more special group in this type of patient - Sanyang patients.
of these patients, in the CLEOPATRA study chose to use two-target plus chemotherapy rescue therapy, in the maintenance of dual-target therapy.
but based on clinical practice and real-world research data, such patients can be rescued with dual-target and chemotherapy treatment, and then double-target plus endocrine maintenance therapy.
, where the tumor load is very small, the first line of rescue treatment of dual-target and endocrine can be considered.
Patients who failed to treat antibody drugs after the use of antibody-type therapy drugs, the previously less available treatment options, the mid-PFS time of the treatment of viruloid monoanti-chemotherapy or rapatini-carpedal sucrose was about 8 months, followed by the birth of the ADC treatment drug T-DM1 medium PFS time can be extended to 9.6 months, and significant OS benefits.
later listed, the pythonic and Capetambin could have benefited from better PFS, with the median PFS event approaching one year, with the longest PFS data reported to be 12.5 months.
latest drug, DS-8201, is currently available in the U.S., and it's similar to traditional T-DM1, where antibody drugs are closopree monoantigens, different ways of linking, and even chemotherapy drugs.
ORR can reach 60.9% in patients with HER2-positive advanced breast cancer who have relapsed or failed antibody therapy after treatment of antibody drugs, and the medium PFS can reach 16.4 months. Based on the above study, CSCO BC guidelines for antibody therapy drugs after relapse / recurrence of metastasis after antibody drug treatment failure patients, grade I recommended pyrithione and carpetamine, level II recommended the use of T-DM1 or Rapatinib - carpetamine alone.
Knot in the treatment of HER2-positive advanced breast cancer patients, we must first carry out a layered management, considering the patient's past treatment, for patients who have not used antibody drugs or meet the principle of antibody drug re-use, first-line treatment can be preferred to proper dual-target and chemotherapy treatment.
For patients who fail to treat antibody drugs after the use of antibody drugs or after relapse metastasis, according to the principle of individualized treatment, patients with recurrence metastasis within 6 months should be given priority in choosing second-line treatment options T-DM1 or pyridoxine;
Based on the above clinical data, in the era of no antibody therapy drugs, the medium OS is only about 15 months; Medical Forum Network Source: Medical Forum Network Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Met Medical" or "Source: MedSci Original" are owned by Metz Medicine and are not authorized to be reproduced by any media, website or individual, and must be reproduced with the words "Source: Mets Medicine".
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