Trastuzumab Combined With Chemotherapy or Endocrine Therapy to Treat Metastatic Luminal B2 Breast Cancer

Inclusion Criteria

• •1. Age 18 years or older.
• •2. Patients with an Eastern Cooperative Oncology Group (ECOG) score of 0 or 1.
• •3. Histologically confirmed metastatic or local recurrence of breast cancer.
• •4. ER positive and/or progesterone receptor (PR) positive, HER-2+ defined as immuno-histochemistry3+ staining or FISH+.
• •5. Prior adjuvant Trastuzumab therapy is permitted, but disease-free interval (DFI) must be more than 12 months.
• •6. Patients must have measurable or evaluable disease.
• •7. Adequate bone marrow reserve with neutrophils \> 1000 and platelets \> 100,000.
• •8. Adequate renal function with serum creatinine \< 2.0.
• •9. Adequate hepatic reserve with serum bilirubin \< 2.0, alanine transaminase(ALT) \< 3 times the upper limit of normal, and alkaline phosphatase \< 5 times the upper limit of normal.
• •10. Adequate cardiac reserve with at least 45% of Left ventricular ejection fraction (LVEF) by echocardiogram.
• •11. Able to give informed consent.
• •12. Life expectancy of at least 12 weeks.