Document Detail


Integrating trastuzumab in the neoadjuvant treatment of primary breast cancer: accumulating evidence of efficacy, synergy and safety.
MedLine Citation:
PMID:  17766143     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neoadjuvant chemotherapy is used in non-metastatic breast cancer in order to eradicate micrometastatic deposits early during disease course, as well as in order to decrease tumour bulk and render surgery feasible or breast-conserving. Moreover, it offers promise to serve as an in vivo chemosensitivity assay and as a powerful predictive factor for outcome. Trastuzumab, a monoclonal antibody targeting an epitope in the extracellular domain of the Human Epidermal Growth Factor Receptor-2 (HER2/erbB-2), was found to be active in HER2-overexpressing metastatic as well as in resected breast cancer when given post-operatively. In this review, we summarise the evidence on the activity and safety of trastuzumab-containing neoadjuvant chemotherapy for the management of women with localised, irresectable or resectable breast cancer. Twenty-three published studies enrolling a total of 585 patients reported pathologic complete responses (pCR) ranging from 7 to 78% with a favourable adverse event profile, data that are presented and discussed in this review. The impact of trastuzumab on long-term outcome, the identification of surrogate biomarkers for sensitivity or resistance to antineoplastic therapy, the optimal schedule of trastuzumab administration and the more active chemotherapeutic regimen for synergism are only a few of the key points needing elucidation so as to rationalise trastuzumab-based approaches.
Authors:
George Lazaridis; George Pentheroudakis; Nicholas Pavlidis
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-09-04
Journal Detail:
Title:  Critical reviews in oncology/hematology     Volume:  66     ISSN:  1040-8428     ISO Abbreviation:  Crit. Rev. Oncol. Hematol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-10     Completed Date:  2008-05-13     Revised Date:  2013-05-08    
Medline Journal Info:
Nlm Unique ID:  8916049     Medline TA:  Crit Rev Oncol Hematol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  31-41     Citation Subset:  IM    
Affiliation:
Department of Medical Oncology, Ioannina University Hospital, Niarxou Avenue, 45500 Ioannina, Greece.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized
Antineoplastic Agents / therapeutic use*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Breast Neoplasms / chemistry,  drug therapy*
Clinical Trials as Topic
Drug Synergism
Female
Humans
Neoadjuvant Therapy
Receptor, erbB-2 / analysis
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antineoplastic Agents; EC 2.7.10.1/ERBB2 protein, human; EC 2.7.10.1/Receptor, erbB-2; P188ANX8CK/trastuzumab

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