APPLICATION OF LAPATINIB IN PATIENTS WITH HER-2 POSITIVE METASTATIC BREAST CANCER
##article.abstract##
Relevance. Initially, HER2-positive breast cancer was one of the most
aggressive types of this disease, which was characterized by a very rapid tumor growth
rate, a high risk of disease relapse and the appearance of distant metastases. In
developed countries, in the structure of cancer incidence in women, breast cancer (BC)
ranks 1st or 2nd (20–25% of all cancer cases). More than half of patients with breast
cancer develop distant metastases at one stage or another of the disease. Metastatic
breast cancer (mBC ) is an incurable disease, but modern treatment approaches allow
achieving clinically significant results. The identification of more and more new
molecular genetic and immunohistochemical markers and their correlations makes it
possible to individualize treatment tactics for patients [1]. The most significant factors
for poor prognosis in mBC include overexpression of HER2, a transmembrane receptor
with tyrosine kinase activity, which is the result of amplification of the HER2 gene on
chromosome 17 [2,3,11]. Studies have shown that the HER2-positive subtype is more
common among young women with advanced stages of the disease, is characterized by
high aggression and rapid dissemination of the tumor process, and does not depend on
the size of the tumor. Even with minimal carcinoma sizes and in the absence of
involvement of regional lymph nodes, HER2 overexpression is associated with an
unfavorable course of the disease [3, 4]. Today, determination of HER2 status in breast
cancer is mandatory for all stages of the disease; it is necessary to assess the prognosis
and develop an optimal treatment algorithm. Determination of HER2 status in a tumor
is standardized and is performed on paraffin blocks of the tumor using
immunohistochemical analysis and, in case of questionable analysis results (HER2-
2+), is supplemented by determining gene amplification using in hybridization situ
(ISH) [5–7]. Anti-HER2 therapy is currently the standard approach to the treatment of
breast cancer patients with HER2 overexpression or HER2 gene amplification and
usually complements chemotherapy or hormonal therapy [14,15]. Lapatinib is an
antibody-drug conjugate that delivers the latter directly to HER2-positive cancer cells,
thereby limiting damage to healthy tissue [8,9,12]. The use of Lapatinib can increase
efficacy and achieve tumor control in young patients with HER-2 positive mBC .
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