常见的陆劲松 乳腺癌的内分泌治疗进展 last02 07 print.pptVIP

* BIG1-98序贯治疗与单药治疗的71个月随访结果对DFS的分析数据显示,与他莫昔芬序贯来曲唑相比,来曲唑单药的DFS改善的趋势(HR为1.05）；与来曲唑序贯他莫昔芬相比，来曲唑单药的DFS相近(HR为0.96)。 研究结果显示无论患者淋巴结状态如何，随着治疗时间的延长，来曲唑单药治疗组乳腺癌复发率均低于他莫昔芬序贯来曲唑治疗组。 对于淋巴结阳性患者，随着治疗时间的延长，来曲唑单药治疗组患者的乳腺癌复发率显著低于他莫昔芬序贯来曲唑治疗组 对于淋巴结阴性患者，他莫昔芬治疗2年后换用来曲唑治疗能显著降低患者的乳腺癌复发风险 * 对于所有患者而言，来曲唑单药治疗组与来曲唑序贯他莫昔芬治疗组相比，乳腺癌复发率无显著差异： 对于淋巴结阳性患者，随着治疗时间的延长，来曲唑单药治疗组与来曲唑序贯他莫昔芬治疗组相比，患者的乳腺癌复发率无显著差异。 对于淋巴结阴性患者，来曲唑序贯他莫昔芬治疗组的患者乳腺癌复发率高于来曲唑单药治疗组。 BIG 1-98序贯治疗与单药治疗的71个月随访结果显示，与他莫昔芬序贯来曲唑相比，来曲唑单药的DFS、OS和TDR有改善的趋势（HR分别为1.05、1.13和1.22)；与来曲唑序贯他莫昔芬相比，来曲唑单药的DFS、OS和TDR相近(HR分别为0.96、0.90和1.05)。 按淋巴结状态分层，不管淋巴结阴性还是淋巴结阳性的患者，依西美坦组与他莫昔芬序贯依西美坦组之间无显著差异。 * 病理学亚组分析显示，HER2/3阴性表达为依西美坦治疗获益大于他莫昔芬的预测因子。 * * ‘Zoladex’ (goserelin) is a synthetic agonist analogue of naturally occurring luteinising hormone releasing hormone (LHRH), which is a decapeptide Goserelin differs from LHRH itself at residues 6 and 10 along the decapeptide chain The abbreviated formula of goserelin is D-Ser(But)6,Azgly10-LHRH * ZEBRA = ‘Zoladex’ 3.6mg Early Breast Cancer Research Association 斑马试验：“诺雷得在早期乳腺癌研究协作组”的缩写 CMF方案为: 环磷酰胺 (500mg/m2, i.v，d1, 8； 或 100 mg/m2, 口服，d 1-14) 甲氨喋呤 (40mg/m2, i.v.，d1, 8) 氟尿嘧啶 (600mg/m2, i.v.，d 1, 8) CMF组, 环磷酰胺的给药83%病人接受 i.v.， 17% 接受口服 * The Kaplan–Meier DFS curves show a consistent effect up to 9 years (median follow-up 6 years) * Analyses of overall survival reflected the results seen for DFS, although the confidence intervals were wider as a result of the reduced maturity of the overall survival data In ER+ patients, there is a trend towards equivalence for ‘Zoladex’ 3.6mg and CMF with respect to overall survival In ER– patients, CMF was superior to ‘Zoladex’ 3.6mg with respect to overall survival * This trial was set up in 1990 to compare the efficacy of the endocrine combination of ‘Zoladex’ 3.6mg plus tamoxifen with that of CMF chemotherapy in hormone receptor-positive early breast cancer * * 8 * * * * * * * Zoledronic acid improved disease-free survival by a relative 36% (P = .012) compared with placebo