HER2阳性乳腺癌首选的一线药物NCCN2015v3

Preferred first-line agents for HER2-positive disease:Pertuzumab + trastuzumab + docetaxel●Pertuzumab 840 mg IV day 1 Followed by 420 mg IV●

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Preferred first-line agents for HER2-positive disease:

Pertuzumab + trastuzumab + docetaxel

●Pertuzumab 840 mg IV day 1 Followed by 420 mg IV

●Trastuzumab 8 mg/kg IV day 1 Followed by 6 mg/kg IV

●Docetaxel 75-100 mg/m2 IV day 1

Cycled every 21 days.

Pertuzumab + trastuzumab + paclitaxel

●Pertuzumab 840 mg IV day 1 Followed by 420 mg IV Cycled every 21 days

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV Cycled every 21 days

●Paclitaxel 80 mg/m2 IV day 1 weekly or

●Paclitaxel 175 mg/m2 day 1 Cycled every 21 days

Other first-line agents for HER2-positive disease:

Paclitaxel/carboplatin + trastuzumab

●Carboplatin AUC 6 IV day 1

●Paclitaxel 175 mg/m2 IV day 1

Cycled every 21 days.

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV every 21 days

Weekly paclitaxel/carboplatin + trastuzumab

●Paclitaxel 80 mg/m2 IV days 1, 8, & 15

●Carboplatin AUC 2 IV days 1, 8, & 15

Cycled every 28 days.

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV every 21 days

Trastuzumab + paclitaxel

●Paclitaxel

▲175 mg/m2 IV day 1 Cycled every 21 days

or

▲80-90 mg/m2 IV day 1 weekly

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV every 21 days

Trastuzumab + docetaxel

●Docetaxel

▲80-100 mg/m2 IV day 1 Cycled every 21 days

or

▲35 mg/m2 IV days 1, 8, and 15 weekly

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV every 21 days

Trastuzumab + vinorelbine

●Vinorelbine

▲25 mg/m2 IV day 1 weekly

or

▲30-35 mg/m2 IV days 1 and 8

Cycled every 21 days.

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV every 21 days

Trastuzumab + capecitabine

●Capecitabine 1000-1250 mg/m2 PO twice daily days 1-14

Cycled every 21 days

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV every 21 days

Preferred agents for trastuzumab-exposed HER2-positive disease:

Ado-trastuzumab emtansine (T-DM1)

●3.6 mg/kg IV day 1

Cycled every 21 days.

Other agents for trastuzumab-exposed HER2-positive disease:

lapatinib + capecitabine

●Lapatinib 1250 mg PO daily days 1-21

●Capecitabine 1000 mg/m2 PO twice daily days 1-14

Cycled every 21 days.

Trastuzumab + capecitabine

●Capecitabine 1000-1250 mg/m2 PO twice daily days 1-14

Cycled every 21 days.

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV every 21 days

Trastuzumab + lapatinib

●Lapatinib 1000 mg PO daily

●Trastuzumab

▲4 mg/kg IV day 1 Followed by 2 mg/kg IV weekly

or

▲8 mg/kg IV day 1 Followed by 6 mg/kg IV every 21 days

HER2阳性疾病首选的一线药物:

帕妥珠单抗+曲妥珠单抗+多西他赛

●帕妥珠单抗840mg IV d1然后420mg IV

●曲妥珠单抗8mg/kg IV d1然后6mg/kg IV

●多西他赛75-100mg/㎡ iv d1

每21天重复。

帕妥珠单抗+曲妥珠单抗+紫杉醇

●帕妥珠单抗840mg IV d1然后420mg IV 每21天重复

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg IV每21天重复

●紫杉醇80mg/㎡ iv d1每周1次

●紫杉醇175mg/㎡ d1每21天重复

HER2阳性疾病其它的一线药物:

紫杉醇/卡铂+曲妥珠单抗

●卡铂AUC 6 IV d1

●紫杉醇175mg/㎡ iv d1

每21天重复。

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg iv q21d

每周1次紫杉醇/卡铂+曲妥珠单抗

●紫杉醇80mg/㎡iv第1、8、15天

●卡铂AUC 2 IV 第1、8、15天

每28天为1周期。

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg iv q21d

紫杉醇+曲妥珠单抗

●紫杉醇

▲175mg/㎡ iv d1每21天重复

▲80-90mg/㎡ iv d1每周1次

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg iv q21d

曲妥珠单抗+多西他赛

●多西他赛

▲80-100mg/㎡ iv d1每21天重复

▲35mg/㎡iv第1、8、15天每周1次

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg iv q21d

曲妥珠单抗+长春瑞滨

●长春瑞滨

▲25mg/㎡ iv d1每周1次

▲30-35mg/㎡iv第1、8天

每21天重复。

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg iv q21d

曲妥珠单抗+卡培他滨

●卡培他滨1000-1250mg/㎡PO bid d1-14

每21天重复

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg iv q21d

暴露于曲妥珠单抗的HER2阳性疾病首选的药物:

抗体偶联曲妥珠单抗(T-DM1)

●3.6mg/kg IV d1

每21天重复。

暴露于曲妥珠单抗的HER2阳性疾病其它的药物:

拉帕替尼+卡培他滨

●拉帕替尼1250mg PO qd d1-21

●卡培他滨1000mg/㎡PO bid d1-14

每21天重复。

曲妥珠单抗+卡培他滨

●卡培他滨1000-1250mg/㎡PO bid d1-14

每21天重复。

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg iv q21d

曲妥珠单抗+拉帕替尼

●拉帕替尼1000mg PO qd

●曲妥珠单抗

▲4mg/kg IV d1然后2mg/kg iv qw

▲8mg/kg IV d1然后6mg/kg iv q21d

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