Neoadjuvant Chemotherapy for Her2-Positive Breast Cancer Using Trastuzumab and Pertuzumab

Abstract

Breast cancer is the most common malignant tumor in women. HER2-positive (HER2+) breast cancer is a molecular subtype characterized by an aggressive course, a tendency for tumor cells to spread rapidly, and resistance to standard cytostatic regimens. A number of large randomized trials have shown that the use of neoadjuvant chemotherapy provides the same overall survival rates as adjuvant regimens. In addition, the use of neoadjuvant chemotherapy makes it possible to achieve therapeutic pathomorphosis. The discovery of new chemotherapeutic drugs has made it possible to use a dual blockade of HER2 receptors due to interaction with different subdomains of this protein. In particular, chemotherapy using Trastuzumab, Pertuzumab, and Docetaxel has proven to be an effective regimen to achieve high rates of therapeutic pathomorphosis and survival. The paper analyzes the mechanism of action and effectiveness of the combined use of Trastuzumab and Pertuzumab, presents two clinical cases of practical treatment using dual targeted blockade.