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asco乳腺癌内分泌治疗进展刘冬耕课件
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
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