Neoadjuvant Treatment With Trastuzumab in HER۲-Positive Breast Cancer: systematic review

As the most common cancer among cancers with ۲.۳ million cases per year, breast cancer (BC) is a major problem that is estimated to reach ۴.۴ million by ۲۰۷۰ based on evidence. Breast cancer accounts for approximately ۲۴.۵% of all cancer cases and ۱۵.۵% of cancer deaths. This cancer is a very heterogeneous neoplasm with distinct subtypes. Approximately ۲۰% of women with breast cancer have tumors that overexpress human epidermal growth factor receptor ۲ (HER۲). Therefore, there is an urgent need to predict the best response to treatment and choose the right optimal treatment to minimize the possible damage of this cancer. Research has shown that the combination of trastuzumab significantly increases median progression-free survival and reduces mortality. Trastuzumab is an anti-epidermal growth factor ۲ (HER۲) monoclonal antibody compound that binds close to the transmembrane domain and inhibits HER۲ dimerization, helping to slow or stop the growth of cancer cells. Therefore, in our review article, we addressed the neoadjuvant treatment with trastuzumab in HER۲-positive breast cancer. Method: This study was conducted according to PRISMA guidelines. To conduct this review, we performed a comprehensive search in relevant databases including PubMed, SCOPUS, and Google Scholar with the keywords "breast cancer," "trastuzumab," "target therapy," "human epidermal growth factor receptor ۲," and "Neoadjuvant . We did treatment from ۲۰۰۵ to ۲۰۲۲. All articles were in English and studies investigating neoadjuvant treatment with trastuzumab in HER۲-positive breast cancer were included. Result: Based on the inclusion and exclusion criteria, ۷۰۰ articles were first identified, which were most related to our chosen title by removing systematic, narrative, press review articles, conference abstracts, and theses. All ۱۵ articles were clinical trials and different immunohistochemical methods and microscopic analyses were used. All articles examined the course of disease after intravenous administration of trastuzumab between ۱۷ and ۵۲ infusions in standard regimens over one year. The average progression-free survival among patients during one year was ۵۶% and ۱۳.۵ months. Conclusion: According to the studies, trastuzumab seems to have durable antitumor activity in the population of patients treated with HER۲-positive metastatic breast cancer and leads to better progression-free survival and overall results. The risk of disease progression or death was also lower among those who received trastuzumab than those who did not. The most common side effects during trastuzumab treatment were decreased neutrophil count, anemia and nausea. However, larger studies are needed to confirm this.

کلیدواژه ها:

breast cancer ، trastuzumab ، target therapy ، human epidermal growth factor receptor ۲ ، Neoadjuvant