Grechukhina KS, Sukhova MV, Kolyago EM, Filonenko DA, Zhukova LG. Evolution of anti-HER2 therapy in advanced HER2+ breast cancer or “why is trastuzumab still a key player?”. A review. Journal of Modern Oncology. 2025;27(1):19–25. DOI: 10.26442/18151434.2025.1.202822
Эволюция анти-HER2 терапии при распространенном HER2+ раке молочной железы, или «почему трастузумаб до сих пор остается ключевым игроком?»
Гречухина К.С., Сухова М.В., Коляго Е.М., Филоненко Д.А., Жукова Л.Г. Эволюция анти-HER2 терапии при распространенном HER2+ раке молочной железы, или «почему трастузумаб до сих пор остается ключевым игроком?». Современная Онкология. 2025;27(1):19–25. DOI: 10.26442/18151434.2025.1.202822
Grechukhina KS, Sukhova MV, Kolyago EM, Filonenko DA, Zhukova LG. Evolution of anti-HER2 therapy in advanced HER2+ breast cancer or “why is trastuzumab still a key player?”. A review. Journal of Modern Oncology. 2025;27(1):19–25. DOI: 10.26442/18151434.2025.1.202822
Применение анти-HER2 терапии – терапии, блокирующей активность эпидермального фактора роста человека (HER2), позволило кардинально изменить прогноз пациенток с HER2+ раком молочной железы как на ранней, так и на распространенной стадиях. Новые опции, которые демонстрируют эффективность лечения больных HER2+ метастатическим раком молочной железы, позволяют значимо увеличить медиану выживаемости без прогрессирования и общую выживаемость, частоту объективного ответа и его длительность. Некоторые из них по-прежнему одобрены только в 1-й линии терапии метастатической формы либо в нео- или адъювантном режимах, например пертузумаб. В то же время создаваемые противоопухолевые конъюгаты, такие как трастузумаб эмтанзин или трастузумаб дерукстекан, имеют в своем строении общее звено – моноклональное базовое антитело трастузумаб. Несмотря на весь успех данного класса препаратов, на определенном этапе у пациенток наступает прогрессирование, и именно трастузумаб в комбинации с различными химиотерапевтическими режимами и/или препаратами других классов остается стандартом поздних линий терапии и обеспечивает продление жизни больных.
The use of anti-HER2 therapy has dramatically changed the prognosis of patients with HER2+ breast cancer both in the early and advanced stages. New options that demonstrate the effectiveness of treatment of patients with HER2+ breast cancer can significantly increase the median progression-free survival and the overall frequency of objective response, the duration of this response. Some of them are still approved only in the first-line treatment of the metastatic form, either neo- or adjuvant regimens (for example, pertuzumab). At the same time, the antitumor conjugates being created, such as T-DM1 or T-DxD, have a common link in their structure – the monoclonal base antibody trastuzumab. Despite all the success of this class of drugs, progression occurs at a certain stage in these patients, and it is trastuzumab in combination with various chemotherapeutic regimens and/or drugs of other classes that remains the standard of late-line therapy and ensures the prolongation of patients' lives.
Keywords: breast cancer, HER2+ subtype, anti-HER2 therapy, antitumor conjugates, trastuzumab
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1. Bedard PL, Hyman DM, Davids MS, Siu LL. Small molecules, big impact: 20 years of targeted therapy in oncology. Lancet. 2020;395(10229):1078-88. DOI:10.1016/S0140-6736(20)30164-1
2. Cho HS, Mason K, Ramyar KX, et al. Structure of the extracellular region of HER2 alone and in complex with the Herceptin Fab. Nature. 2003;421(6924):756-60. DOI:10.1038/nature01392
3. Rubin I, Yarden Y. The basic biology of HER2. Ann Oncol. 2001;12(Suppl. 1):S3-8. DOI:10.1093/annonc/12.suppl_1.s3
4. Najjar MK, Manore SG, Regua AT, Lo HW. Antibody-Drug Conjugates for the Treatment of HER2-Positive Breast Cancer. Genes (Basel). 2022;13(11). DOI:10.3390/genes13112065
5. Yarden Y, Sliwkowski MX. Untangling the ErbB signalling network. Nat Rev Mol Cell Biol. 2001;2(2):127-37. DOI:10.1038/35052073
6. Van Cutsem E, Bang YJ, Feng-Yi F, et al. HER2 screening data from ToGA: targeting HER2 in gastric and gastroesophageal junction cancer. Gastric Cancer. 2015;18(3):476-84. DOI:10.1007/s10120-014-0402-y
7. Vu T, Claret FX. Trastuzumab: updated mechanisms of action and resistance in breast cancer. Front Oncol. 2012;2:62. DOI:10.3389/fonc.2012.00062
8. Ravdin P. The use of HER2 testing in the management of breast cancer. Semin Oncol. 2000;27(5 Suppl. 9):33-42.
9. Capelan M, Pugliano L, De Azambuja E, et al. Pertuzumab: new hope for patients with HER2-positive breast cancer. Ann Oncol. 2013;24(2):273-82. DOI:10.1093/annonc/mds328
10. Shi Y, Fan X, Deng H, et al. Trastuzumab triggers phagocytic killing of high HER2 cancer cells in vitro and in vivo by interaction with Fcγ receptors on macrophages. J Immunol. 2015;194(9):4379-86. DOI:10.4049/jimmunol.1402891
11. Junttila TT, Akita RW, Parsons K, et al. Ligand-independent HER2/HER3/PI3K complex is disrupted by trastuzumab and is effectively inhibited by the PI3K inhibitor GDC-0941. Cancer Cell. 2009;15(5):429-40. DOI:10.1016/j.ccr.2009.03.020
12. Park S, Jiang Z, Mortenson ED, et al. The therapeutic effect of anti-HER2/neu antibody depends on both innate and adaptive immunity. Cancer Cell. 2010;18(2):160-70. DOI:10.1016/j.ccr.2010.06.014
13. Perez EA, Romond EH, Suman VJ, et al. Trastuzumab plus adjuvant chemotherapy for human epidermal growth factor receptor 2-positive breast cancer: planned joint analysis of overall survival from NSABP B-31 and NCCTG N9831. J Clin Oncol. 2014;32(33):3744-52. DOI:10.1200/JCO.2014.55.5730
14. Cameron D, Piccart-Gebhart MJ, Gelber RD, et al. 11 years' follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial. Lancet. 2017;389(10075):1195-205. DOI:10.1016/S0140-6736(16)32616-2
15. Slamon D, Eiermann W, Robert N, et al. Abstract S5-04: Ten year follow-up of BCIRG-006 comparing doxorubicin plus cyclophosphamide followed by docetaxel (AC→T) with doxorubicin plus cyclophosphamide followed by docetaxel and trastuzumab (AC→TH) with docetaxel, carboplatin and trastuzumab (TCH) in HER2+ early breast cancer. Cancer Res. 2016;76(Suppl.4):S5-04. DOI:10.1158/1538-7445.SABCS15-S5-04
16. Kolyadina IV, Poddubnaya IV. Key studies that have changed the history and treatment of early HER2+ breast cancer: focus on individual therapy. Tumors of Female Reproductive System. 2020;16(3):46-56 (in Russian). DOI:10.17650/1994-4098-2020-16-3-46-55
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ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия
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Katerina S. Grechukhina*, Margarita V. Sukhova, Elena M. Kolyago, Daria A. Filonenko, Liudmila G. Zhukova
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