绝经前HR+乳腺癌需要辅助化疗同时使用OFS.pptVIP

* 8814临床试验，将1477例绝经后，N+ ER+ 随机分三组，分别接受TAM 5年，CAF6周期同时TAM5年，CAF6周期序贯TAM5年， Intergroup研究是一项多中心、随机临床研究，比较诺雷得 vs. 卵巢切除的疗效。纳入绝经前HR+转移性乳腺癌患者138例，分为诺雷得组 3.6mg/月(n=69)和卵巢切除组 (n=67)，主要终点指标：FFS（无失败生存），OS（总生存）。结果显示，诺雷得药物去势组的无失败无治疗失败生存与卵巢切除组相当，中位无治疗失败生存期为6个月，卵巢切除组为4个月。两者没有统计学的差异。 * * AHA, American Heart Association; apo, apolipoprotein; AR, androgen receptor; AT1 receptor, angiotensin II type 1 receptor; BMI, body mass index; CAC, coronary artery calcium; CAD, coronary artery disease; COX-2, cyclo-oxygenase- 2; CRP, C-reactive protein; CVD, cardiovascular disease; DHEA, dehydroepiandrosterone; DHT, 5α-dihydrotestosterone; ER, oestrogen receptor; GPCR, G-protein-coupled receptor; GPER, G-protein-coupled ER; HAEC, human aortic endothelial cell; HDL, high-density lipoprotein; HRT, hormone replacement therapy; HUVEC, human umbilical vein endothelial cell; ICAM-1, intercellular adhesion molecule-1; IL, interleukin; LDL, low-density lipoprotein; LDLR, LDL receptor; LPS, lipopolysaccharide; MCP-1, monocyte chemotactic protein-1; MPA, medroxyprogesterone acetate; NF-κB, nuclear factor κB;; iNOS, inducible NOS; PAI-1, plasminogen activator inhibitor-1; PR, progesterone receptor; ROS, reactive oxidative species; RT– PCR, reverse transcription–PCR; SERM, selective ER modulator; TLR4, Toll-like receptor 4; TNF-α, tumour necrosis factor-α; 延迟：最近的最大的干预性研究：WHI women began hormone replacement therapy at an average age of 63.3 years, 早期：停经开始时 * Patnaik et al. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Research 2011, 13:R64 来自美国SEER数据库63566例的流行病学调查显示，66岁以上诊断乳腺癌患者，中位随访9年，死亡原因首位为心血管事件。在所有人群中15.9%为心血管死亡，为首要死亡事件，乳腺癌死亡占15.1%， A total of 63,566 women diagnosed with breast cancer at age 66 or older between 1992 and 2000 met the inclusion criteria and were followed for a median of approximately nine years. Fully adjusted relative hazards of the effects of comorbidities on