Breast cancer– the most common type of cancer affecting women – is often thought of as a single disease. However, mounting evidence suggests that there are多个子类型, all of which occur at different rates, have varying levels of aggressiveness, and respond to different types of treatment.

One of the better understood subtypes isHER2-positive乳腺癌，由HER2蛋白的高表达定义。患有HER2阳性乳腺癌的妇女经常接受针对性疗法的治疗trastuzumab, which has dramatically improvedsurvival rates从HER2-positive breast cancer in the past decade.

治疗HER2阳性乳腺癌的进展

在一个Q&A podcast出版于BMC医学to launch our乳腺癌的聚光灯article collection,Sunil Verma从Sunnybrook Medical Centeroutlines the 30-year journey from the discovery of the HER2 gene in 1984 to the successful treatment of many patients with HER2-positive breast cancer. Verma explains that the use of trastuzumab has decreased the risk of breast cancer recurrence by around 50% when used in the辅助设置, and has transformed our approach to treating breast cancer.

Unfortunately, trastuzumab resistance develops in some patients, and many who initially respond to treatment develop resistance一年之内开始疗法。在一个Minireview文章，Pernelle Lavaud和Fabrice André从Gustave Roussy Cancer Centeroutline strategies to overcome trastuzumab resistance, which include dual inhibition of the HER2 protein with trastuzumab pluspertuzumab，将HER2指导的疗法与化学疗法结合在一起，并开发抗体 - 药物结合物。

Verma, who has led pioneering clinical trials showing that the antibody-drug conjugateT-DM1（曲妥珠单抗Emtansine）扩展了患有晚期HER2阳性乳腺癌女性的生存，强调了：

“ T-DM1不仅扩展了生存率，而且与标准治疗相比，它的毒性较小，副作用较少……现在，对于在第一线抗HER2治疗后进步的患者，T-DM1被认为是标准护理。”

The latest evidence from the phase IIITh3RESA randomized trialindicates that T-DM1 improves progression-free survival in metastatic breast cancer patients from 3.3 months to 6.2 months when compared with physician’s choice therapy, without any additional adverse events.

HER2阳性乳腺癌的下一步是什么？

展望未来，Lavaud和André将正在研究的其他蛋白质描述为克服曲妥珠单抗抗性的治疗靶标，包括致癌稳定剂HSP90和the编程死亡1信号通路. The authors conclude that:

“Since several different targets are under investigation, there is a need to identify predictive biomarkers to optimize combination strategies…[and] facilitate the selection of appropriate patients who can benefit from personalized targeted therapy.”

时描述自己理想的总目标pproach’ in the early breast cancer setting, with chemotherapy-free treatment regimens for the majority of patients, in order to improve treatment outcome while reducing side effects.

下一代是否在乳腺癌诊所进行了有价值的工具？

尽管基于HER2和雌激素受体等蛋白质的表达，分子亚型在乳腺癌诊所被广泛用于对患者进行分层和指导治疗决策，但使用多重基因组测定仍存在争议。在一个论坛文章出版于BMC医学，乳腺癌专家辩论是否next-generation sequencing（NGS）已准备好常规临床使用，如在31^st年度迈阿密乳腺癌会议.Debu Tripathy从德克萨斯大学医学博士安德森癌症中心explains that NGS provides information on gene sequences, copy numbers and gene translocations within a tumor.

Kathleen Harnden andKimberly Blackwell从杜克大学医学院advocate NGS as a valuable clinical tool to identify mutations that can be targeted therapeutically, identify prognostic information and inform clinical trial design. On the other hand,Mark Robson从纪念斯隆·克特林癌症中心argues that while NGS is a valuable research tool, it does not yet have a place in routine clinical care. Robson explains that mutations identified through NGS may not be targetable using current therapies, and mutations may not have clinical relevance. All authors agree that NGS could be useful to identify those likely to benefit from inclusion in new clinical trials, and we hope that the results of genome-directed clinical trials will provide further insights into whether NGS can be incorporated into routine clinical care.

所有这些文章都是BMC医学的一部分乳腺癌的聚光灯Article Collection已于今天推出，现已开放进行研究提交。该系列的目的是highlight the latest progress across all areas of breast cancer medicine, including clinical studies of new therapies, molecular genomics and translational advances. If you have any research you would like us to consider for inclusion in this article collection, please emailbmcmedicineeditorial@biomedcentral.com

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