Erken Evre HER-2 Pozitif Meme Kanseri Hastalardında Adjuvan Anti-HER-2 Tedavi
Özet
Meme kanseri kadınlarda es sık görülen ve ölüme neden olan kanserdir. Bu hastaların yaklaşıl %15’inde HER-2 amplifikasyonu mevcuttur. Buna yönelik anti-HER-2 tedaviler bu hastalara uygulanmalıdır. Neoadjuvan kemoterapi almadan opere olan hastalara primer kitlesi 2 cm’den büyükse ve/veya lenf nodu pozitifse ikili anti-HER-2 tedavi uygulanmalıdır. Primer kitlesi 2 cm’nin altında olan ve lenf nodu negatif olan hastalara ise tek ajan trastuzumab tedavisi uygulanmalıdır. Anti-HER-2 tedavilerin kardiyotoksisite riski nedeni ile antrasiklin içeren kemoterapi rejimleri ile ardışık olarak; antasiklin içermeyen kemoterapi rejimleri ile ise eş zamanlı olarak uygulanmalıdır. Neoadjuvan anti-HER-2 tedavi sonrası opere olan hastalarda rezidü kitle 1 cm’den büyükse ve/veya lenf nodu pozitifse adjuvan dönemde 14 kür T-DM-1 tedavisi uygulanmalıdır. Neoadjuvan anti-HER-2 tedavi sonrası opere olan hastalarda rezidü kitle 1 cm altında ve lenf nodu negatifse veya patolojik tam yanıt mevcutsa adjuvan trastuzumab tedavisi 1 yıla tamamlanmalıdır.
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