Luminal型乳腺癌的治疗难点和应对策略

Challenges and countermeasures in the treatment of luminal breast cancer

Luminal型乳腺癌是最常见的乳腺癌分型,约占乳腺癌的60%以上,其治疗难点在于内分泌治疗耐药和远期复发。针对内分泌治疗耐药,应根据不同的通路机制从多角度入手,可用高剂量氟维司群抑制雌激素受体通路,或加用各类靶向药物阻断非雌激素受体通路。为降低Luminal型乳腺癌远期复发的风险,则应建立复发预测模型,延长高危复发患者内分泌治疗的时限,加用卵巢去势或血管生成抑制剂。以Luminal型乳腺癌治疗难点指导科学研究,将研究成果回归临床应用,最终优化临床治疗策略。

Luminal breast cancer is the most common subtype of breast cancer,representing more than 60%of all breast cancers.Endocrine resistance and late recurrence are two challenges in the treatment of luminal breast cancer.To overcome endocrine resistance in multiple levels,high-dose-fulvestrant can inhibit estrogen-receptor(ER)-dependent pathways,while targeted drugs can block ER-independent pathways.To reduce the risk of late recurrence in luminal breast cancer,recurrence prediction model should be formed.For patients with high risk of late recurrence,extended endocrine therapy,combination of ovarian function suppression(OFS)or vascular endothelial growth factor(VEGF)inhibitor could be utilized.Based on the challenges of the treatment,scientific research achievements can be used in clinical practice,and finally optimize the clinical treatment strategy.