R.N. Safin¹, R.Sh. Khasanov²
¹Republican Clinical Oncological Dispensary named after Professor M.Z. Sigal, Kazan
²KSMA — branch campus of the FSBEIFPE RMACPE MOH Russia, Kazan
Safin R.N. — oncologist, Head of the Chemotherapy Department No. 1
29 Sibirskiy trakt St., 420029 Kazan, Russian Federation, tel.: +7-917-272-79-93, e-mail: rustem1408@mail.ru, ORCID ID: 0000-0003-0585-7727
Abstract. Breast cancer is the most common form of malignant neoplasms in the female population in the world. The choice of treatment tactics is based on the disease stage and the tumor molecular biological characteristics. It includes various combinations of drug therapy, surgical treatment, and radiation therapy. Neoadjuvant drug therapy for breast cancer is an important element in the treatment of local and regional forms of the disease. Despite the use of double anti-HER2 blockade in modern neoadjuvant chemotherapy regimes, there is a pool of patients with a residual tumor and, consequently, an unfavorable prognosis for overall and event-free survival. The selection of this group of patients is important in order to personalize treatment, which will avoid performing toxic but potentially ineffective therapy and choose a targeted treatment effective for a particular patient. To this end, a number of studies analyzed the effect of steroid hormone receptors, immune responses, and molecular variations of key oncogenes on the pathomorphological response of tumors during neoadjuvant chemotherapy. This article analyzes the key research conducted on this topic over the past 20 years.
Key words: HER2-positive breast cancer, neoadjuvant chemotherapy, pathomorphological response, refractoriness, trastuzumab, pertuzumab