辉瑞乳腺癌内分泌治疗.pptxVIP

乳腺癌内分泌治疗;;;;;乳腺癌发病的最关键因素—雌激素作用;综合治疗（立体治疗）;对乳腺癌认识的演变;Hippocrates和Galen的black bile学说;Halstedian theory ;Halsted’s radical mastectomy 19th~20th(50yrs);Fisherian theory ;;Spectrum theory;乳癌内分泌治疗的挑战;Endocrine pathways and the breast;;卵巢切除;Sir George Thomas Beatson, He took his degree from Clare College, Cambridge, in 1869, studied medicine at Edinburgh University. He was later examiner in surgery at Edinburgh; Consulting Surgeon to Glasgow Infirmary and Chairman of the Scottish Branch of the Royal Red Cross Society end the St. Andrews Ambulance Association. He died at Glasgow in 1933;Hierarchy of evidence on ovarian ablation for breast cancer Continued maintenance of the review;SERMs;Tamoxifen evidence (adjuvant);Tamoxifen for early breast cancer: an overview of the randomised trials Early Breast Cancer Trialists Collaborative Group;Optimal Duration of Therapy ; ;Tamoxifen and risk of endometrial cancer ;Risk and prognosis of endometrial cancer after tamoxifen for breast cancer Liesbeth Bergman;The risk of venous thromboembolic disease associated with adjuvant hormone therapy for breast carcinomaSteven R. Deitcher, M.D. *, Marcelo P. V. Gomes, M.D.;肾上腺切除;New Stars in the Sky of Treatment for Early Breast CancerMartine J. Piccart-Gebhart, M.D., Ph.D.;Cumulative distribution of breast cancer diagnoses by age;;? 芳香化酶抑制剂在辅助内分泌治疗中的试验设计 ? ;Classification;Efficacy;ATAC:Disease-free survival (HR-positive population);BIG1-98:;MA.17 : Disease-Free Survival; Coombes RC et al. N Engl J Med. 2004; 350: 1081–1092;ABCSG/ARNO:Event-free survival;ITA: disease-free survival;Why approved AI?adjuvant?;When to use AIs? ---problem Initial vs.Sequential;Smoothed hazard rates for recurrence;ER+ PR-与HER2;Dowsett, M. San Antonio 2003;BIG1-98:;;A comparison of the proportional risk reduction of adjuvant tamoxifen therapy based on PgR status in populations of ER-positive patients ;;The clinical significance of epidermal growth factor receptor (EGF-R) in human breast cancer: a review o