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Chiến lược điều trị ung thư vú dương tính với HER2
Tóm tắt
Các khối u dương tính với HER2 chiếm khoảng 18–20% tổng số các loại ung thư vú. Những khối u này có xu hướng ác tính hơn các khối u âm tính với HER2 và liên quan đến tiên lượng xấu hơn. Việc xác định sự biểu hiện quá mức HER2, thông qua việc nhuộm miễn dịch hóa học với độ hỗ trợ từ 3+ đối với protein HER2 hoặc khuếch đại gen HER2 bằng phương pháp lai huỳnh quang tại chỗ, nên được sử dụng để lựa chọn bệnh nhân cho liệu pháp kháng HER2. Các phác đồ chứa trastuzumab nên được khuyến nghị cho phụ nữ mắc ung thư vú di căn dương tính với HER2 như là liệu pháp hàng đầu. Việc tiếp tục sử dụng trastuzumab kết hợp với capecitabine đã mang lại lợi ích lâm sàng đáng kể so với việc chỉ sử dụng capecitabine ở những phụ nữ có sự tiến triển trong quá trình điều trị trastuzumab. Một phác đồ phụ trợ chứa trastuzumab cũng nên được khuyến nghị cho tất cả những phụ nữ có nguy cơ trung bình hoặc cao với ung thư vú sớm dương tính với HER2. Chức năng tim nên được theo dõi định kỳ trong suốt quá trình điều trị này. Nhiều loại thuốc chống HER2 cho ung thư vú đang được phát triển. Các cơ chế cơ bản của tác dụng của chúng và sự xuất hiện của khả năng kháng đang được làm rõ từng bước. Trong trung hạn hoặc dài hạn, các thử nghiệm lâm sàng so sánh các loại thuốc này sẽ được tiến hành cho đến khi có các loại thuốc có hiệu quả lâm sàng và dễ sử dụng thực sự. Việc tìm kiếm các dấu hiệu sinh học cho từng loại thuốc đang được tiến hành một cách quyết liệt. Vị trí của "thuốc thích hợp cho bệnh nhân thích hợp" sẽ ngày càng được củng cố hơn.
Từ khóa
#ung thư vú #HER2 #trastuzumab #điều trị kháng HER2 #khối u ác tínhTài liệu tham khảo
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