王晓稼---进展期乳腺癌姑息治疗进展--20061111.pptVIP

THANKS！ * * * Recent Advnace in Breast Cancer Therapy Xiaojia. Wang, M.D.Ph.D Medical Oncology Zhejiang Cancer Hospital Hangzhou, 310022 P. R. of China Decreased Mortality Rate in Breast Cancer Complexity of Breast Cancer ER/PR Status Menopausal Status Her2/neu Status Axillary Node Status Other Prognostic Factors Histological Feature Mastectomy /Lumpectomy +/-Axillary Dissection Radiation Therapy Adjuvant Therapy Neoadjuvant Therapy Chemotherapy…regimen ? Hormonal therapy Tamoxifen ? AI ? HER2 IHC -FISH Herceptin Single/Chemo Combination Hormonal Therapy Palliative Therapy Chemotherapy…regimen ? Hormonal therapy ? Chemotherapy…regimen ? Combo/sequence ? Hormonal therapy Tamoxifen ? AI ? Sequence ? Biological Therapy Sentinal Node Biopsy Adjuvant Chemotherapy 排列組合 AC TAC ET XT CP CAF FEC AT GT H H+CP 化療程式 臨床試驗代號 NSABP B28 ATAC IES ITA BCIRG ??? A C F T E P M X H G Alphabet Soup Standard Adjuvant Chemotherapy CMF x 6 = CMF x 12 = Tamoxifen Cyclophosphamide 50 mg/m2 PO qd x 14 d Methotrexate 50 mg/m2 IVP D1 and D8 5-FU 500 mg/m2 IVP D1 and D8 Cycle repeat q 4 w AC or EC x 4 = CMF x 6 Cyclophosphamide 600 mg/m2 IV Day 1 Adriamycin 60 mg/m2 IV Day 1 Or Epirubicin 75-100 mg/m2 IV Day 1 CAF or FEC x 6 AC x 4 or CMF Cycle repeat q 4 w Cycle repeat q 3 w Cycle repeat q 3 w ● ● ● ● E100 x 4 = CMF x 4 Adjuvant Chemotherapy Schedules Conventional Q3W Combination Sequential G-CSF G-CSF G-CSF G-CSF Dose Dense- Same Dose Q2W + G-CSF G-CSF G-CSF Dose Dense Metronomic – Daily Dose + G-CSF Anti-angiogenic Metronomic Standard Adjuvant Chemotherapy EC x 4 = T x 4 Cyclophosphamide 50 mg/m2 PO qd x 14 d FEC x3 = D x 3 Cycle repeat q 3 w for 4 Cycles ● ● ● Adriamycin 60 mg/m2 IV Day 1 Paclitaxel 175 mg/m2 IV Day 1 Cycle repeat q 3 w for 4 Cycles ddEC x 4 = ddT x 4 Or Epirubicin 75-100 mg/m2 IV Day 1 G-CSF Support, Cycle repeat q 2 w for 4 Cycles Role of Taxane in Ad