Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press76610.17650/1994-4098-2020-16-3-46-55MAMMOLOGY. ORIGINAL REPORTSМАММОЛОГИЯ. ОРИГИНАЛЬНЫЕ СТАТЬИKey studies that have changed the history and treatment of early HER2+ breast cancer: focus on individual therapyКлючевые исследования, изменившие историю и принципы лечения раннего HER2+ рака молочной железы: фокус на индивидуализацию терапииhttps://orcid.org/0000-0002-1124-6802KolyadinaI. V.КолядинаИ. В.
Russian Federation

2/1 Barrikadnaya St., Moscow 1259934 Akademika Oparina St., Moscow 117198

Ирина Владимировна Колядина

125993 Москва, ул. Баррикадная, 2/1, стр. 1117997 Москва, ул. Академика Опарина, 4 

irinakolyadina@yandex.comhttps://orcid.org/0000-0002-0995-1801PoddubnayaI. V.ПоддубнаяИ. В.
Russian Federation

2/1 Barrikadnaya St., Moscow 125993

125993 Москва, ул. Баррикадная, 2/1, стр. 1

Russian Medical Academy of Postgraduate Education, Ministry of Health of RussiaФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииV.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова» Минздрава России01122020163465612012021120120212020https://ojrs.abvpress.ru/ojrs/article/view/766

HER2-positive breast cancer is a unique subtype of the disease, not only in terms of aggressive biology, but also in terms of treatment options. Over the past 15 years, the strategy for treating early HER2-positive breast cancer has undergone a real evolution – from the absence of anti-HER2 therapy to the sequential introduction of adjuvant, neoadjuvant and post neoadjuvant approaches. This review describes key studies of systemic therapy for HER2-positive breast cancer stage I–III, which made it possible to establish clear priorities in the sequence of surgical and systemic steps, identify high risk groups which need of escalation of treatment, and determine the optimal anti-HER2 therapy for each steps, as well as de-escalation of stage I treatment without losing its effectiveness. The news from the latest cancer conferences (SABCS, ESMO, ASCO) on the impact of various biological markers on the effectiveness of anti-HER2 agents is presented. A clear concept of modern treatment of early HER2-positive breast cancer has been formed, allowing individualized approaches, and achieving better results of the therapy this aggressive biological subtype.

HER2+ рак молочной железы является уникальным вариантом заболевания с позиции не только агрессивной биологии, но и возможностей лечения. В течение последних 15 лет лечебная стратегия раннего HER2+ рака молочной железы претерпела настоящую эволюцию от полного отсутствия анти-HER2 терапии до последовательного введения адъювантного, неоадъювантного и постнеоадъювантного этапов. В настоящем обзоре представлены ключевые исследования лекарственной терапии HER2+ РМЖ I–III стадии, благодаря которым удалось расставить четкие приоритеты в последовательности хирургического и лекарственного этапов, выделить группы риска, нуждающиеся в эскалации лечения, определить оптимальную анти-HER2 терапию для каждого этапа , а также деэскалировать лечение I стадии без потери его эффективности. Представлены последние новости крупных онкологических конференций (SABCS, ESMO, ASCO) о влиянии различных биологических маркеров на эффективность анти-HER2 агентов. Сформирована четкая концепция современного лечения раннего HER2+ рака молочной железы, которая позволяет индивидуализировать подходы и добиться наилучших результатов терапии при таком агрессивном биологическом подтипе заболевания.

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