2005092306上海乳癌会议.pdf

2005上海国际乳腺癌论坛 暨第八届全国乳腺癌会议 大会特邀讲座 Matti S. Aapro 毕业于瑞士日内瓦大学医学部，目 前担任瑞士Genolier肿瘤综合治疗研 究所主任和癌症支持治疗多国协作 会主席，Annals of Oncology 杂志副 主编，曾经担任欧洲癌症研究与治 疗组织（EORTC ）的秘书长，以及 老年肿瘤学国际协会的执行主席 Strengths and weaknesses of the StGallen consensus From personnal notes taken by M. AAPRO Genolier These slides are NOT an official version Thanking Dr A. Costa for help and Dr A. Goldhirsch and Dr B. Thurlimann for comments Adjuvant Therapy of Breast Cancer: Does St Gallen ‘05 provide a new « standard »? NO! St Gallen is a series of expert opinions There are remarkable contradictions One needs to understand the « St Gallen methodology » CHOICE IS BASED ON ENDOCRINE RESPONSIVENESS • All but one panelist agreed • Suggestion based among others on: – K Albain SABCS 2004 ( INT 0100 / SWOG 8814): no effect of FAC in patients ER+ Her neg 1-3 pos nodes… and ER was not prognostic – D Berry SABCS 2004: CALGB 8541/9344/9741 trials showed ER neg pts to benefit from CT • but ER + to have modest / no benefit from CT Total score = PS+IS (range 0, 2–8) Proportion score (PS) 0 1 2 3 4 5 1/100 1/10 1/3 2/3 100% Intensity score (IS) 0 = negative 1 = weak 2 = intermediate 3 = strong Allred DC 1998; Elledge RM 2000 Is there a condition of unclear or uncertain endocrine responsiveness? YES 96.4 % NO 3.6 % Abstain 0 %