课件：三阴性乳腺癌的治疗进展吴新红.pptVIP

PARP1 in Breast Cancer PARP1 mRNA level 700 600 500 400 300 200 100 0 Normal IDC Mean 99.9%UCL 99%UCL 95%UCL 90%UCL IDC Subtype % PARP1 upregulation Normal 2.9% IDC 30.2% ER+ 22.9% ER- 55.6% PR+ 23.1% PR- 45.0% HER2+ 29.2% HER2- 70.0% ER+/PR+/HER2+ 20.0% ER-/PR-/HER2- 80.0% *defined by percentage of samples exceeding the 95% UCL of normal tissue distribution Infiltrating ductal carcinoma (IDC) is a highly invasive tumor, accounting for 70-80% of all breast malignancies IDC shows statistically significant PARP1 upregulation in comparison with normal breast tissues: p = 2x10-27 PARP1 is upregulated in TNBC The rate of clinical benefit from 34% to 56% (P=0.01) The rate of overall response from 32% to 52% (P=0.02). PFS：3.6 M to 5.9 M (hazard ratio for progression, 0.59; P=0.01) OS： 7.7 M to 12.3 M (hazard ratio for death, 0.57; P=0.01). (9）Radiotherapy for TNBC Haffty等对442（100TNBC)例保乳手术乳腺癌进行了分析,比较局部复发和远处转移 TNBC的OS(67%对75%,P=0.096)、无远处转移生存率(61%对75%,P=0.002)、特异性生存率(67%对78%,P=0.03)和无淋巴结转移生存率(93%对99%,P=0.021) 局部控制率方面没有差异(均为83%),证明了其对放射线的敏感性 （10）TNBC: Ongoing Clinical Trials Numerous prospective trials ongoing to evaluate various therapeutic options specifically in TNBC population 57 open trials currently listed on clinicaltrials.gov Most include TNBC populations only Studies include targeted agents, vaccines Across stages of disease （11）TNBC: Conclusions TNBC is a distinct subtype of BC and is associated with treatment challenges due to its aggressive nature TNBC has no specific target…yet Antracycline and taxane work (but not very well…) Molecular pathways that control tumor development could determine treatment Platinum-based chemotherapy is emerging as backbone of new treatments Introduction of novel agents (PARPi) is showing promise—iniparib Results from ongoing phase III trials will help determine the best treatment strategy Treat ment choices in TNBC TODAY TOMORROW Chemotherapy Chemotherapy Chemotherapy Tailored chemotherapy Molecular targ