5.2.1　HER-2 Positive Adjuvant Therapy

HER-2 overexpression in breast cancer is one of the indications for adjuvant chemotherapy.For patients with N1 and above，T2 and above，the chemotherapy regimen chooses anthracycline combined with purple shirt and trastuzumab.The CSCO guidelines recommended for high risk in 2019.Patients at risk（lymph node positive，hormone receptor negative）used a dual-target regimen and AC-TH+P was recommended as a grade Ⅱ.The update was based on the APHINITY study［5］.The enrolled patients were lymph node-positive or high-risk node-negative，operable HER-2-positive breast cancers from 549 centers and 43 countries.A total of 4，805 cases were randomly divided into two.All patients underwent adjuvant chemotherapy，standard 1-year trastuzumab therapy，and pertuzumab or placebo.The primary endpoint of the study was invasive-disease-free survival（iDFS）.Invasive events were significantly lower in the pertuzumab group than in the control group（7.1%vs 8.7%），and the 3-year iDFS pertuzumab group was estimated to be higher in the study than in the placebo group（94.1%vs 93.2%，HR=0.81，P=0.045），HER-2 positive patients had a 19%reduction in risk of recurrence or death.Subgroup analysis showed greater benefit from lymph node-positive patients（92.0%vs 90.2%，HR=0.77，95%CI，0.62）～0.96，P=0.02）.(https://www.daowen.com)