Prolonged complete remission of metastatic HER2-positive breast cancer after continuous trastuzumab treatment: a case report and review of the literature
Prolonged complete remission of metastatic HER2-positive breast cancer after continuous trastuzumab treatment: a case report and review of the literature
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DOI：
10.1007/s11523-014-0350-9
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发表时间：
2015-06-01
影响因子：
5.4
通讯作者：
Dedes, Konstantin J.
中科院分区：
文献类型：
--
作者：
Arcienega, Isabel Ihnenfeld;Imesch, Patrick;Dedes, Konstantin J.
转移性乳腺癌被认为是一种不治之症。然而，针对人表皮生长因子受体2 （HER2）的靶向治疗可显著提高转移性HER2阳性乳腺癌患者的生存率。有些病人可能会有长期的完全缓解。关于长期曲妥珠单抗的安全性和曲妥珠单抗停药后复发风险的证据有限。我们提出一例81岁的患者与her2扩增转移性乳腺癌（MBC）在肝脏。在局部治疗后，紫杉烷为基础的化疗联合曲妥珠单抗导致曲妥珠单抗维持治疗21个月后放射学完全缓解。6年后，患者仍处于完全缓解期，并继续接受曲妥珠单抗作为维持治疗。对于转移性her2阳性乳腺癌，在曲妥珠单抗为基础的治疗方案下完全缓解的病例可以在一些患者中观察到延长缓解。回顾文献中发表的少数可用病例，这些患者具有一些共同特征：激素受体阴性疾病和转移到肝脏。没有证据表明曲妥珠单抗维持治疗在一段时间后可以安全中断。
Metastatic breast cancer is considered an incurable disease. Targeted treatments against the human epidermal growth factor receptor 2 (HER2), however, significantly improve survival in patients with metastatic HER2-positive breast cancer. Some patients may respond with prolonged complete remission. Evidence on safety of long-term trastuzumab and risk of relapse after trastuzumab cessation is limited. We present a case of an 81-year-old patient with HER2-amplified metastatic breast cancer (MBC) in the liver. Following taxane-based chemotherapy in combination with trastuzumab after local treatment resulted in a complete radiological remission after 21 months of trastuzumab maintenance therapy. The patient remains in complete remission 6 years later and continues to receive trastuzumab as maintenance therapy. Prolonged remission in cases with complete response under trastuzumab-based regimens for metastatic HER2-positive breast cancer can be observed in some patients. Reviewing the few available cases published in the literature, these patients share some common characteristics: hormone receptor negative disease and metastases to the liver. There is no evidence that trastuzumab maintenance treatment can be safely interrupted after a certain time period.