乳腺癌新辅助化疗的共识与争议

Neoadjuvant chemotherapy in breast cancer of consensuses and controversial perspectives

新辅助化疗作为乳腺癌系统性治疗的重要组成部分,在逐渐形成各项共识的同时也引发适应证和治疗策略相关的争议。在适应证界定方面,不宜盲目遵从临床试验的结果,需明确新辅助化疗在临床实践中的目的,严格把控适应证。在治疗策略方面,应根据不同乳腺癌分子分型进行差异性选择,以新辅助化疗的疗效为导向,筛选早期疗效欠佳的人群,改进化疗策略或及早进行局部治疗。精准医学的发展能够促进药物开发,帮助个体化制定新辅助化疗方案。厘清乳腺癌新辅助化疗争议点,把控适应证并优化治疗策略,进一步提高乳腺癌患者的生存预后。

Neoadjuvant chemotherapy(NACT)is a vital part of the systemic treatment to breast cancer.With the formation of consensuses on NACT,controversial perspectives on NACT have been widely discussed,especially in the fields of indication and therapeutic strategy.To define the indication of NACT,blind obedience to the results of clinical trials is not recommended.Instead,indications of NACT should be strictly controlled based on the targets of the clinical practice.Oriented by the early effectiveness of NACT,various chemotherapy or local therapeutics for different molecular subtypes of breast cancer should be conducted to the patients with unsatisfied effect.What′s more,the evolvement of precision medicine accelerates the research of drugs and helps to form an individualized NACT plan.After clarifying the controversial opinions towards NACT in breast cancer,controlling the indication and optimizing the therapeutic strategy will improve the survival of breast cancer patients.