阴性乳腺癌的治疗进展吴新红.pptVIP

（10）TNBC: Ongoing Clinical Trials Numerous prospective trials ongoing to evaluate various therapeutic options specifically in TNBC population 57 open trials currently listed on clinicaltrials.gov Most include TNBC populations only Studies include targeted agents, vaccines Across stages of disease （11）TNBC: Conclusions TNBC is a distinct subtype of BC and is associated with treatment challenges due to its aggressive nature TNBC has no specific target…yet Antracycline and taxane work (but not very well…) Molecular pathways that control tumor development could determine treatment Platinum-based chemotherapy is emerging as backbone of new treatments Introduction of novel agents (PARPi) is showing promise—iniparib Results from ongoing phase III trials will help determine the best treatment strategy Treat ment choices in TNBC TODAY TOMORROW Chemotherapy Chemotherapy Chemotherapy Tailored chemotherapy Molecular targeted therapies * * * * 三阴性乳腺癌的治疗现状 湖北省肿瘤医院乳腺科 吴 新 红 2011年St Gallen共识乳腺癌亚型 亚型 定义 Luminal A型 ER和（或）PR阳性，HER2阴性，Ki67低表达（＜14%） Luminal B型 Luminal B（HER2阴性），ER和（或）PR阳性，HER2阴性，Ki67高表达（≥14%） Luminal B（HER2阳性），ER和（或）PR阳性，HER2过表达或增殖，Ki67任何水平 HER-2过表达型 HER2阳性（非Luminal），ER和PR缺失，HER2过表达或增殖 基底样型 三阴性（导管），ER和PR缺失，HER2阴性 一、三阴性乳腺癌（TNBC） : 概念 Triple negative andbasal-like Basal but not triple negative 15-40% are ER+, PR+ or HER2+ Triple negative but not basal Clinical assay(IHC) Gene arrays ER- / PgR- / HER2- BRCA1、Basal-Like 、TNBC乳腺癌的关系 Leslie K. et al. Adv. Anat. Pathol. 2007; 14: 419-430 Basal-like Triple Negative BRCA1 二、TNBC的风险因素(排除 BRCA 状态) Younger age at menarche Higher parity Younger age at full term pregnancy Shorter duration of breast feeding High body mass index (BMI) High waist to hip ratio Lack of exercise Fulford et al, Histopathology 2006; Livasy et al, Mod Pathol, 2006, Bauer KR Cancer 2007 Carey JAMA 2006 三、TNBC预后因素 Large tumor size Presence of nodal metastasis Presence of dista