tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2020-10-2-4tumors-741Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL REPORTSРоль неоадъювантного подхода в лечении первично операбельного HER2-позитивного рака молочной железыThe role of the neoadjuvant approach in the treatment of primary operable HER2 positive breast cancerФроловаМ. А.FrolovaM. A.

Мона А. Фролова, к. м. н., старший научный сотрудник отделения клинической фармакологии и химиотерапии

Москва

Mona A. Frolova, MD, PhD, Leader Researcher at Department of Clinical Pharmacology and Chemotherapy

Moscow

ГлазковаЕ. В.GlazkovaЕ. V.

Елена В. Глазкова, аспирант отделения клинической фармакологии

Москва

Elena V. Glazkova, Postgraduate Student at Department of Clinical Pharmacology

Moscow

ПетровскийА. В.PetrovskyA. V.

Александр В. Петровский, к. м. н., заместитель директора по образовательной деятельности

Москва

Alexandr V. Petrovsky, MD, PhD, Deputy Director for for Educational Activities

Moscow

КрохинаО. В.KrokhinaО. V.

Ольга В. Крохина, к. м. н., маммолог, хирург-онколог, старший научный сотрудник отделения реконструктивной и пластической онкохирургии

Москва

Olga V. Krokhina, MD, PhD, Breast Oncologist, Senior Researcher at Department of Reconstructive and Plastic Oncologic Surgery

Moscow

СтенинаМ. Б.SteninaM. В.

Марина Б. Стенина, д. м. н., ведущий научный сотрудник отделения клинической фармакологии

Москва

Marina B. Stenina, MD, PhD, DSc, Leading Researcher at Department of Clinical Pharmacology

Moscow

ТюляндинС. А.TyulyandinS. A.

Сергей А. Тюляндин, д. м. н., профессор, заместитель директора по научной работе, заведующий отделением клинической фармакологии и химиотерапии

Москва

Sergey A. Tyulyandin, MD, PhD, DSc, Prof, Deputy Director for Research, Head of Department of Clinical Pharmacology and Chemotherapy

Moscow

ФГУБ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияN. N. Blokhin National Medical Research Center of OncologyRussian Federation2020311220201024552Copyright © Фролова М.А., Глазкова Е.В., Петровский А.В., Крохина О.В., Стенина М.Б., Тюляндин С.А., 20202020Фролова М.А., Глазкова Е.В., Петровский А.В., Крохина О.В., Стенина М.Б., Тюляндин С.А.Frolova M.A., Glazkova Е.V., Petrovsky A.V., Krokhina О.V., Stenina M.В., Tyulyandin S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/741

Неоадъювантная системная терапия является важной составляющей комплексного лечения первично операбельного HER2-позитивного рака молочной железы (РМЖ). В связи с этим чрезвычайно важным представляется поиск факторов, предсказывающих эффективность лечения, а также оптимальной системы оценки ответа опухоли. В исследовании проведен анализ факторов, предсказывающих достижение полной патоморфологической регрессии (пПР) при люминальном и нелюминальном HER2-позитивных подтипах. Морфологическая оценка ответа опухоли на лечение проводилась по системе RCB, также изучены дополнительные характеристики резидуальной опухоли. Показано, что комплексная оценка, включающая систему RCB и уровень Ki67, позволяет разделить больных на прогностические группы и индивидуализировать тактику адъювантной терапии.

Neoadjuvant systemic therapy is an essential component of the comprehensive treatment of primary operable HER2‑positive breast cancer. Therefore, it is extremely important to search for treatment efficacy predictors and optimal system for assessing tumor response to treatment. The study analyzed factors predicting pathological complete response (pCR) in patients with luminal and non‑luminal HER2‑positive tumor subtypes. The morphological assessment of the tumor response to treatment was carried out using the RCB system; additional characteristics of the residual tumor were studied as well. It was shown that a comprehensive assessment involving the use of the RCB system and determination of the Ki ‑ 67 level helps to divide patients into prognostic groups and individualize the adjuvant therapy plan.

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The authors declare that there are no conflicts of interest present.