title: Primary systemic therapy in HER2-amplified breast cancer: a clinical review.
abstract: Primary systemic therapy (PST) in early breast cancer is utilized in locally advanced breast tumors and when breast-conserving surgery is desirable. In addition, the PST setting provides an opportunity to monitor response including histopathological and biomarker examination of the tumor and host tissues before and after systemic therapy. Trastuzumab is a monoclonal antibody targeting the hEGF receptor that is overexpressed in 15-20% of breast tumors. Trastuzumab is effective in prolonging survival when used to treat women with hEGF receptor overexpressed tumors, both in adjuvant and metastatic disease settings. Trastuzumab has also shown promising activity in PST/neoadjuvant studies by achieving high rates of complete pathologic response. This is a review of clinical studies that incorporated trastuzumab in PST and/or neoadjuvant chemotherapy, including the results of recently reported studies using trastuzumab in combination with other novel therapies such as lapatinib or pertuzumab.
authors.affiliation: School of Medicine of Deakin University, Geelong VIC 3220, Australia. m.khasraw@deakin.edu.au
authors.forename: Mustafa
authors.initials: M
authors.lastname: Khasraw
authors.forename: Richard
authors.initials: R
authors.lastname: Bell
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery*; D016190:Carboplatin / Q000008:administration & dosage; D000068579:Celecoxib; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D000077143:Docetaxel; D005260:Female; D006801:Humans; D000077341:Lapatinib; D015412:Mastectomy, Segmental; D017239:Paclitaxel / Q000008:administration & dosage; D011720:Pyrazoles / Q000008:administration & dosage; D011799:Quinazolines / Q000008:administration & dosage / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D013449:Sulfonamides / Q000008:administration & dosage; D043823:Taxoids / Q000008:administration & dosage; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab; D016190:Carboplatin; D000068579:Celecoxib; D000077143:Docetaxel; D000077341:Lapatinib; D017239:Paclitaxel; D011720:Pyrazoles; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D013449:Sulfonamides; D043823:Taxoids; D000068878:Trastuzumab; C508053:ERBB2 protein, human