Abstract: Neoadjuvant therapy for hormone receptor-positive/HER-2 positive breast cancer        WANG Chao- bin,WANG Shu. Breast Center of Peking University People's Hospital, Beijing 100044, China 
Corresponding author: WANG Shu, E- mail: wangshu@pkuph. edu.cn
Abstract    Human epidermal growth factor receptor 2（HER-2） positive breast cancer includes hormone receptor-positive and hormone receptor-negative patients. Hormone receptor-positive/HER-2positive breast cancer was promoted by dual signaling pathways, and there is crosstalk between them. The pCR rate of neoadjuvant therapy in hormone-receptor positive patients is lower than that of hormone-receptor negative patients. The strengthening and optimization of neoadjuvant therapy for these patients can be explored from the following three strategies: dual-target therapy combined with traditional endocrine therapy or enhanced endocrine therapy, strengthening of anti-HER  -2 therapy combined with endocrine therapy, and endocrine combined targeted therapy as optimization treatment. There have been exploratory studies with small sample that have conducted corresponding explorations on the above treatment strategies, but the results are not consistent. Therefore, for hormone receptor-positive/HER-2 positive early breast cancer, chemotherapy combined with targeted therapy is still the standard treatment of neoadjuvant therapy. At the same time, more large-sample studies and long-term follow-up results were expected to provide more evidence-based medicine, so that patients can receive more appropriate treatment. 

Key words: breast cancer, human epidermal growth factor receptor-2 positive, hormone receptor-positive, neoadjuvant therapy

摘要： 人类表皮生长因子受体-2（HER-2）阳性乳腺癌包括激素受体阳性及激素受体阴性乳腺癌，激素受体阳性、HER-2阳性乳腺癌两条信号通路共同作用促进肿瘤细胞增殖，且两条信号通路之间存在交互作用，这部分病人新辅助化疗联合靶向治疗的病理完全缓解（pCR）率低于激素受体阴性病人。针对这部分病人新辅助治疗的强化及优化可以从以下三个方向进行探索：标准双靶治疗基础上联合传统内分泌治疗或强化的内分泌治疗、抗HER-2治疗的进一步强化联合或不联合内分泌治疗、内分泌联合靶向的降阶优化治疗。已有小样本研究就上述三种治疗策略进行了相应的探索，结果并不十分一致。因此，对于激素受体阳性、HER-2阳性的早期乳腺癌，化疗联合靶向治疗仍然是新辅助治疗的标准方案，同时也期待更多大样本的研究及长期随访结果提供更多的循证医学证据，使病人得到更加精准的治疗。

关键词: 乳腺癌, 人类表皮生长因子受体-2阳性, 激素受体阳性, 新辅助治疗