2012-2013年乳腺癌内科治疗进展

Advance in medical therapy of breast cancer from 2012 to 2013

乳腺癌作为一类预后较好,生存期相对较长的瘤种,内科治疗在综合治疗中具有举足轻重的地位。近年来,乳腺癌新辅助治疗在针对不同分子分型的个体化治疗方面取得了长足进步;靶向药物特别是双靶向药物的研究如火如荼,其中帕妥珠单抗、T-DM1成为继曲妥珠单抗、拉帕替尼后获批的新型抗HER-2靶向药物,它们能够显著提高疗效,并在数个II,III期临床研究的结果中得以确认。ATLAS和aTTOM两项研究结果挑战了传统的5年三苯氧胺辅助治疗绝经前乳腺癌患者的临床规范,并改写NCCN2013乳腺癌指南。双内分泌药物或与mTOR抑制剂的联合应用有望为逆转内分泌耐药寻找新途径。

Medical therapy plays an important role in the combined treatment of breast cancer with a relatively good prognosis.There have been predominant progressions in the molecular type-based neoadjuvant therapy in breast cancer in recent years.Besides,pertuzumab and T-DM1 have been approved by FDA,and shown exciting results in phase II and III studies.However,bevacizumab,an antiangiogenic target agent,is obliged to look for the further advantages.Additionally,the NCCN guideline（2013） has been rewritten based on results of ATLAS and aTTOM studies.Ten years instead of five years of adjuvant tamoxifen for premenopausal patients was recommended.Double endocrine drugs or combination of hormone therapy and mTOR inhibitor are possible to be an approach to reverse the resistance of endocrine therapy.