直到20%的乳腺癌会表达过多HER2蛋白，使得其成为抗体治疗的可靠靶点。在早期HER2阳性乳腺癌中，避免使用蒽环类化疗是一项挑战。基于单臂II期APT试验结果，辅助性紫杉醇/曲妥珠单抗是一种可接受的方案，适用于I期HER2阳性疾病患者。在我们的回顾性研究中，共有240名患者，中位肿瘤大小为12.0mm（IQR 9-15 mm），其中204人（85%）为雌激素受体阳性疾病。在中位随访时间为4.6年后，实际世界3年无疾病存活率、远处无疾病存活率和总体生存率分别为98.8%（95%置信区间（CI）96.2-99.6%）、99.2%（95% CI，96.7-99.8%）和98.3%（95% CI，96.2-99.6%）。在实际世界环境中，辅助性紫杉醇/曲妥珠单抗方案与I期HER2阳性乳腺癌妇女低复发率相关。此外，我们还回顾了其他应用于HER2阳性乳腺癌的治疗优化策略，包括正在进行的尝试。版权所有 © 2023 Elsevier B.V. 发表。

Up to 20% of breast cancer overexpress HER2 protein, making it a reliable target for antibody-based treatments. In early HER2-positive breast cancer avoiding anthracycline-based chemotherapy is a challenge. Based on the single-arm phase II APT trial results, adjuvant paclitaxel/trastuzumab is an accepted regimen for patients with stage I HER2-positive disease. In our retrospective study of 240 patients, the median tumor size was 12.0mm (IQR 9 -15), and 204 (85%) had estrogen receptor-positive disease. After a median follow-up of 4.6 years, 3-year real-world disease-free survival, distant DFS, and overall survival were 98.8% (95% confidence interval (CI), 96.2-99.6), 99.2% (95% CI, 96.7-99.8), and 98.3% (95% CI, 96.2-99.6), respectively. In a real-world setting, an adjuvant paclitaxel/trastuzumab regimen was associated with low recurrence rates among women with stage I, HER2-positive breast cancer. Additionally, we reviewed other treatment optimization strategies attempted or ongoing in HER2-positive breast cancer.Copyright © 2023. Published by Elsevier B.V.