細胞表皮生長因子受體與乳癌標靶治療

Human Epidermal Growth Factor Receptor and Targeted Therapy for Breast Cancer

女性乳癌近來有年輕化與發生率增加趨勢，約三分之一惡性乳癌有人類表皮生長因子第二接受體(human epidermal growth factor receptor 2，HER-2)高度表現或基因增幅放大的病理變化，HER2是細胞膜生長因子接受體的成員之一，是目前乳癌基因標靶治療評估與預後追蹤的重要標記。乳癌治療的標靶治療藥物「賀癌平Trastuzumab (Herceptin)」，是DNA重組的人類化單株抗體，對HER2過度表現的乳癌病患，合併化學藥物一起使用時，控制效果高。本篇主旨在介紹表皮生長因子的生理機制、乳癌患者在HER2表現特性與檢驗方式，以及單株抗體標靶藥物的臨床使用及相關護理照顧。期能讓護理人員對相關資訊有較多認識，而與醫療團隊進行跨領域協調合作，達到提供全人醫療與整合性照護之目標。

In recent years, the incidence of female breast cancer has been increasing and youth oriented. Data have shown that approximately one third of patients with invasive breast cancers had an over-expressed or amplified gene of human epidermal growth factor receptor 2 (HER2). HER2 is a member of the epidermal growth factor receptor (EGFR) family, and has become a critical indicator for the target therapy of breast cancer patients. Trastuzumab (Herceptin) is a monoclonal antibody that targets against the HER2. It has led to significant effect when combined with standard chemotherapies. In this article we reviewed the biomechanics of “epidermal growth factor receptors”, the characteristic of HER2 and the methodology of screen in breast cancer, the use of previous targeted treatments, and the nursing implications related to this new approach to HER2 positive breast cancer. We hope this article may serve as a reference for understanding the further information of targeted therapies and increase the opportunity of transtheoretical cooperation for a comprehensive holistic care.