Abstract:
UNASSIGNED: Chemotherapy has been traditionally used as neo-adjuvant therapy in breast cancer for down-staging of locally advanced disease in all sub-types. In the adjuvant setting, genomic assays have shown that a significant proportion of ER positive/HER2 negative patients do not derive benefit from the addition of chemotherapy to adjuvant endocrine therapy. An interest in hormonal treatments as neo-adjuvant therapies in ER positive/HER2 negative cancers has been borne by their documented success in the adjuvant setting. Moreover, cytotoxic chemotherapy is less effective in ER positive/HER2 negative disease compared with other breast cancer subtypes in obtaining pathologic complete responses.
UNASSIGNED: Neo-adjuvant therapies for ER positive/HER2 negative breast cancers and associated biomarkers are reviewed, using a Medline survey. A focus of discussion is the prediction of patients that are unlikely to derive extra benefit from chemotherapy and have the highest probabilities of benefiting from hormonal and other targeted therapies.
UNASSIGNED: Predictive biomarkers of response to neo-adjuvant chemotherapy and hormonal therapies are instrumental for selecting ER positive/HER2 negative breast cancer patients for each treatment. Chemotherapy remains the standard of care for many of those patients requiring neo-adjuvant treatment, but other neo-adjuvant therapies are increasingly used.
摘要:
■化疗传统上被用作乳腺癌的新辅助疗法,用于降低所有亚型的局部晚期疾病的分期。在佐剂设置中,基因组分析显示,相当比例的ER阳性/HER2阴性患者在辅助内分泌治疗的基础上,化疗并没有获益.在ER阳性/HER2阴性癌症中作为新辅助疗法的激素治疗的兴趣已经由它们在辅助设置中的成功所证明。此外,与其他乳腺癌亚型相比,细胞毒性化疗在ER阳性/HER2阴性疾病中在获得病理完全缓解方面效果较差.
■对ER阳性/HER2阴性乳腺癌的新辅助疗法和相关生物标志物进行综述。使用Medline调查。讨论的焦点是预测不太可能从化疗中获得额外益处并且具有从激素和其他靶向疗法中受益的最高概率的患者。
■新辅助化疗和激素治疗反应的预测性生物标志物有助于选择ER阳性/HER2阴性乳腺癌患者进行每种治疗。化疗仍然是许多需要新辅助治疗的患者的标准护理,但是其他新辅助疗法的使用越来越多。