2014年晚期乳腺癌化疗旅途-答案.ppt

* Targeted therapies for breast cancer Cell growth, proliferation, survival, metastasis, angiogenesis Akt/PKB mTOR S6K1 PI3K 拉帕替尼 依维莫司 EGFR HER2 4E-BP1 elF-4E Protein Synthesis 帕妥珠单抗 PTEN VEGFR 贝伐单抗(撤市) VEGF p p p p p p p p 曲妥珠单抗 Cyclin D CDK4/6 MAPK Cell Cycle PARP DNA damage Apoptosis p p IGFR T-DM1 2007年 晚期乳腺癌：化疗+贝伐单抗 化疗+贝伐单抗：显著延长PFS,未显著延长OS 2012年RIBBON-2研究：贝伐单抗联合二线化疗治疗HER2阴性的疗效 2012年RIBBON-2研究的亚组分析：159例(23%)TNBC患者，中位生存延长 2013-2014年晚期乳腺癌：化疗+贝伐单抗 晚期TNBC：化疗联合+靶向 正在进行中的药物II/III期临床研究 总 结 晚期乳腺癌的治疗现状 –晚期乳腺癌患者的5年生存率20%，化疗是主要治疗手段 –对于蒽环类治疗耐药的晚期乳腺癌患者，GT/CD是指南推荐的一线治疗方案 晚期乳腺癌的旅途 1：维持治疗的突破 对一线治疗有效（CR/PR/SD）患者，尤其是激素受体阴性、内脏转移、 肿瘤负荷大、年轻(不超过50岁)、绝经前的转移性乳腺癌患者， 可考虑继续维持治疗以延长总生存，优化巩固一线疗效；GT继续维持治疗可显著延长PFS和OS分别达12.0个月和36.8个月 晚期乳腺癌的旅途 2：TNBC新标准的探索 2013NCCN指南新增GC方案 晚期TNBC的旅途 3：化疗联合靶向进展 –紫杉醇联合贝伐单抗方案 –化疗联合相关信号通路靶点药物的探索…… 期待------ THANK YOU FOR YOUR ATTENTION * * Docetaxel combinations have been evaluated in the second-line treatment setting of MBC in an effort to improve upon its single-agent activity. This slide depicts a study comparing single agent docetaxel with the combination of docetaxel and capecitabine in 511 patients with anthracycline-pretreated metastatic breast cancer. Compared with single-agent docetaxel, the combination of docetaxel + capecitabine resulted in a significant increase in median time to disease progression (the primary endpoint), median overall survival and objective response rate. * Docetaxel combinations have been evaluated in the second-line treatment setting of MBC in an effort to improve upon its single-agent activity. This slide depicts a study comparing single agent docetaxel with the combination of docetaxel and capecitabine in 511 patients with anthracycline-pretreated metastatic breast cancer. Compared with single-agent docetaxel, the combination of docetaxel + capecitabine resulted in a significant increase in median time to disease progression (the primary endpoint), median overall survival and objec