asco乳腺癌内分泌治疗进展刘冬耕课件.pptxVIP

2013 ASCO 乳腺癌内分泌治疗进展 广州中山大学肿瘤医院 内科 刘冬耕 2013-07-6 湛江 内容 辅助内分泌治疗（延长治疗改善疗效） aTTom ATLAS MA-17 晚期乳腺癌治疗进展（乳腺癌耐药研究进展） BOLERO 2 TANDEM EGF 其他新药 其他研究（包括基础和临床） Recurrences Breast Cancer Deaths 超过半数乳腺癌的复发和死亡出现在他莫昔芬结束后 Adapted with permission. Early Breast Cancer Trialists’ Collaborative Group Meeting, 2000. Years 85.2 76.1 68.2 73.7 62.7 54.9 68% 55% 0 20 40 60 80 100 0 5 10 15 Tamoxifen Control 15% 17% 0 20 40 60 80 100 0 5 10 15 73% 64% 80.9 73.0 87.8 73.2 64.0 Years Tamoxifen Control 9% 18% 91.4 % of patients % of patients 20,187 women with ER-positive or ER-unknown disease randomised in 5 trials of 10 vs 5 years of tamoxifen: ECOG, Scottish NSABP B-14 1,588 ATLAS* 11,646 aTTom 6,953 ALL TRIALS 20,187 * ATLAS, Lancet 2013; 381: 805-16 aTTom: Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer Richard Gray,Daniel Rea,Kelly Handley 17 others on behalf of the aTTom Collaborators 5 years of tamoxifen versus no tamoxifen* 10 vs 5 years of tamoxifen: effect on breast cancer recurrence ASCO 2013 复发率分别为：28%和32%，p=0.003 10 vs 5 years of tamoxifen: Recurrence by year of follow-up 10 vs 5 years of tamoxifen: Breast Cancer Death by Treatment Allocation 10 vs 5 years of tamoxifen: Death after recurrence by year of follow-up 10 vs 5 years of tamoxifen: Death Without Recurrence by Treatment 10 vs 5 years of tamoxifen: All cause mortality by treatment 10 vs 5 years of tamoxifen: Overall survival by treatment and year of follow-up 10 vs 5 years of tamoxifen: Overall survival by treatment and year of follow-up Main risk: endometrial cancers: absolute hazard 0.5%, 10 years 5 years Rate ratio (95%CI) P-value Endometrial cancers 102 (2.9%) 45 (1.3%) 2.20 (1.31-2.34) P0.0001 Endometrial Cancer death 37 (1.1%) 20 (0.6%) 1.83 (1.09-3.09) P=0.02 ATLAS: 6846 women, ER+, 10 vs 5 years tamoxifen ATLAS, Lancet