![]() |
¿¬°£Á¤º¸ ¼ºñ½º
»óǰÄÚµå
1349829
HER2 Àú¹ßÇö ÀüÀ̼º À¯¹æ¾Ï ½ÃÀå : Tumour DeckHER2-Low Metastatic Breast Cancer - Tumour Deck |
HER2 ¹ßÇö ¼öÁØÀÌ ³·°í(HER2 IHC ½ºÄÚ¾î 1 ¶Ç´Â 2·Î Á¤ÀÇ), ERBB2 ÁõÆøÀÌ °ËÃâµÇÁö ¾Ê´Â Á¾¾çÀº ÀÌ HER2 Àú¹ßÇö ÀüÀ̼º À¯¹æ¾Ï ¹üÁÖ¿¡ ¼ÓÇÕ´Ï´Ù. ÀÌ´Â HER2 ¸é¿ªÁ¶Á÷ÈÇÐ(IHC) ½ºÄÚ¾î 1 ¶Ç´Â ½ºÄÚ¾î 2/in situ hybridization(ISH) À½¼º Ç¥ÇöÇüÀ» °¡Áø HER2 À½¼º BCÀÇ »õ·Ó°Ô Á¤ÀÇµÈ ÇÏÀ§ ÁýÇÕÀ¸·Î, IHC/ISH´Â ÇöÀç HER2 ¹ßÇöÀ» Á¤ÀÇÇϱâ À§ÇØ Àû¿ëµÇ°í ÀÖ´Â À¯ÀÏÇÑ Ç¥ÁØ ±â¼úÀÔ´Ï´Ù. ÀÔ´Ï´Ù.
HER2 Àú¹ßÇö ÀüÀ̼º À¯¹æ¾Ï Ä¡·á¹ýÀº ºü¸£°Ô ¹ßÀüÇϰí ÀÖ½À´Ï´Ù. ÃÖ±Ù ÀÓ»ó½ÃÇè¿¡¼ CDK4/6 ¾ïÁ¦Á¦¿Í ³»ºÐºñ ¿ä¹ýÀ» º´¿ëÇÏ´Â °ÍÀÌ Ç¥ÁØ 1Â÷ Ä¡·á·Î È¿°úÀûÀÓÀÌ ÀÔÁõµÇ¾ú½À´Ï´Ù. ¶ÇÇÑ PI3K ¾ïÁ¦Á¦¿Í AKT ¾ïÁ¦Á¦ÀÇ »ç¿ëµµ ÀÓ»ó½ÃÇèÀ» ÅëÇØ °ËÅäµÇ°í ÀÖÀ¸¸ç, °¡±î¿î ½ÃÀÏ ³»¿¡ ´õ ¸¹Àº Ä¡·á ¿É¼ÇÀ» Á¦°øÇÒ ¼ö ÀÖÀ» °ÍÀ¸·Î º¸ÀÔ´Ï´Ù.
HER2 Àú¹ßÇö ÀüÀ̼º À¯¹æ¾ÏÀº À¯¹æ¾ÏÀÇ »õ·Î¿î ¾ÆÇüÀ¸·Î »õ·Î Áø´ÜµÈ À¯¹æ¾ÏÀÇ ¾à 50%-60%¸¦ Â÷ÁöÇÕ´Ï´Ù. ÀÌ´Â HER2 Àú¹ßÇö ÀüÀ̼º À¯¹æ¾ÏÀÌ ºñ±³Àû ÈçÇÑ ¾ÆÇüÀ̸ç, HER2 Àú¹ßÇö À¯¹æ¾ÏÀº HER2 ¹ßÇöÀÌ ÀÖ´õ¶óµµ ÀϹÝÀûÀ¸·Î HER2 À½¼ºÀ¸·Î °£ÁֵǾî Ä¡·áµÇ¸ç, HER2 Àú¹ßÇöÀº HR À¯¹æ¾Ï¿¡¼ ´õ ÈçÇÏÁö¸¸, HR À½¼º À¯¹æ¾Ï¿¡¼µµ ¹ß°ßµÈ´Ù´Â ¿¬±¸ °á°ú°¡ ÀÖ½À´Ï´Ù. ¿¬±¸ °á°ú¿¡ µû¸£¸é HER2 Àú¹ßÇöÀº HR À¯¹æ¾Ï¿¡¼ ´õ ÈçÇÏÁö¸¸, HR À½¼º À¯¹æ¾Ï¿¡¼µµ
ÇöÀç HER2 Àú¹ßÇö ÀüÀ̼º À¯¹æ¾Ï Ä¡·áÀÇ ÁÖ·ù´Â ÈÇпä¹ý, ³»ºÐºñ¿ä¹ý, Ç¥ÀûÄ¡·á µî ´Ù¾çÇÑ Ä¡·á¹ýÀ» °áÇÕÇÏ´Â °ÍÀÔ´Ï´Ù.
ÃÖ±Ù ¼ö³â°£ Ç¥ÀûÄ¡·á°¡ ÀÓ»ó¿¡¼ À¯¸ÁÇÑ Ä¡·á¹ýÀ¸·Î ¶°¿À¸£¸é¼ HER2 ÀúÄ¡ ÀüÀ̼º À¯¹æ¾Ï¿¡ ´ëÇÑ ÇöÀçÀÇ Ç¥ÁØÄ¡·á´Â Ãֱ٠ǥÀûÄ¡·áÀÇ ¹ßÀüÀ¸·Î ºü¸£°Ô ¹ßÀüÇϰí ÀÖ½À´Ï´Ù. ÃÖ±Ù ÀÓ»ó½ÃÇè¿¡¼ »õ·Î¿î HER2 ÁöÇ⼺ Ç×ü-¾à¹° º¹ÇÕü(ADC)°¡ HER2 Àúġȯ¼º Á¾¾ç Ä¡·á¿¡ Å« ÀÓ»óÀû ÀÌÁ¡ÀÌ ÀÖ´Â °ÍÀ¸·Î ÀÔÁõµÇ¾ú½À´Ï´Ù. ÀÌ·¯ÇÑ ADC Áß Çϳª·Î ½ÂÀÎµÈ Æ®·ç½ºÅõÁÖ¸¿-µ¨Å©½ºÅ×Ä(T-Dxd)Àº HER2 Àú¹ßÇö À¯¹æ¾Ï¿¡¼ À¯¸ÁÇÑ °á°ú¸¦ º¸¿©ÁÖ°í ÀÖ½À´Ï´Ù.
Ç¥ÀûÄ¡·á ¿Ü¿¡µµ ³»ºÐºñ¿ä¹ýÀº HER2 Àú¹ßÇö À¯¹æ¾Ï, ƯÈ÷ È£¸£¸ó ¼ö¿ëü ¾ç¼º ȯÀÚ¿¡°Ô Áß¿äÇÑ Ä¡·á ¿É¼ÇÀ̸ç, CDK4/6 ¾ïÁ¦Á¦¿Í ³»ºÐºñ¿ä¹ýÀÇ º´¿ë¿ä¹ýÀº HER2 Àú¹ßÇö À¯¹æ¾Ï ȯÀÚÀÇ ¿¹Èĸ¦ °³¼±ÇÒ ¼ö ÀÖ´Â À¯¸ÁÇÑ Ä¡·á¹ýÀÔ´Ï´Ù.
¼¼°èÀÇ HER2 Àú¹ßÇö ÀüÀ̼º À¯¹æ¾Ï ½ÃÀå¿¡ ´ëÇØ Á¶»çÇßÀ¸¸ç, ½ÃÀå ÇöȲ°ú ÇÔ²² Áõ·Ê¼öÀÇ µ¿Çâ, ȯÀÚ µ¿Çâ, °æÀï Á¦Ç° ½ÃÀå Æ÷Áö¼Å´×, ½ÃÀåÀÇ ±âȸ µîÀ» Á¦°øÇϰí ÀÖ½À´Ï´Ù.
The current clinical definition of HER2-low Breast Cancer (HER2-Low BC) used in clinical practice and ongoing clinical trials relies on the standard IHC and ISH approach; thus, tumors with low level of HER2 expression (defined as a HER2 IHC score of 1+ or 2+) and no detectable ERBB2 amplification fall into this category. It is a newly defined subset of HER2-negative BC that has HER2 immunohistochemical (IHC) score of 1+ or score of 2+/in situ hybridization (ISH) negative phenotype. IHC/ISH is the only standard technique currently applied to define HER2 expression.
"The treatment armamentarium for HER2-low metastatic breast cancer is rapidly evolving. Recent clinical trials have demonstrated the efficacy of CDK4/6 inhibitors in combination with endocrine therapy as a standard first-line treatment option. Additionally, the use of PI3K inhibitors and AKT inhibitors is being explored in clinical trials and may provide further treatment options in the near future."
HER2 low metastatic breast cancer is a new subtype of breast cancer which accounts for approximately 50%-60% of newly diagnosed breast cancer cases. This indicates that HER2 low breast cancer is a relatively common subtype of the disease. Even though HER2-low breast cancer has some HER2 expression, it is generally considered and treated as HER2 negative. Studies have shown that HER2-low expression is more common in HR+ breast cancer, but it can also be found in HR negative breast cancer (Won et al., 2021; Tan et al., 2021).
In recent years, targeted therapies have shown promise in clinical trials and are being explored as alternative treatment options. The current standard of care for HER2-low metastatic breast cancer is rapidly evolving due to recent advancements in targeted therapies. Recent clinical trials have demonstrated significant clinical benefits of novel HER2-directed antibody-drug conjugates (ADCs) in treating HER2-low tumors. One such approved ADC is trastuzumab deruxtecan (T-Dxd), which has shown promising results in HER2-low breast cancer.
In addition to targeted therapies, endocrine therapy is also an important treatment option for HER2-low breast cancer, particularly in patients with hormone receptor-positive disease. Combination therapies, such as CDK4/6 inhibitors in combination with endocrine therapy, have also shown promise in improving outcomes for patients with HER2-low breast cancer.
"It is exciting that we have been able to now translate HER2-targeted therapy to a broader group of patients with HER2-low-expressing breast cancer. Overall, promising responses to T-DXd offer newfound treatment possibilities for a substantial number of patients, many of whom were previously considered to have limited therapeutic options. The recognition of HER2-low status also signals an opportunity to develop more precise, individualized therapeutic approaches through future research."
"We are facing real challenges in terms of [HER2] identification in the clinic, and I would contend that we are in a state of flux in terms of the identification."