Progress in Clinical Research on Drug Resistance and Reversal of Endocrine Therapy in Breast Cancer
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摘要: 激素受体阳性HR + 乳腺癌临床治疗初始阶段依靠内分泌治疗常取得较好的预后,但一旦出现复发和转移,总的预后并不理想,因此近年来内分泌治疗的疗效因耐药性的产生而受到各种限制,内分泌耐药的逆转被认为是让早期激素受体阳性乳腺癌回归慢性疾病治疗的新的方法和希望,延缓和逆转内分泌耐药的策略也逐渐受到临床和科研工作密切的关注。对延缓和逆转内分泌治疗以及应对策略的研究进展作一综述。Abstract: In the initial stage of clinical treatment of hormone receptor positive HR + breast cancer, good prognosis is often achieved by endocrine therapy. Once recurrence and metastasis occur, the overall prognosis is not ideal. Therefore, the efficacy of endocrine therapy is limited by the emergence of drug resistance these years. The reversal of endocrine resistance is considered to be a new method and hope for early hormone receptor positive breast cancer to return to chronic disease treatment. The strategy of delaying and reversing endocrine drug resistance has been paid close attention by clinical and scientific research work. This article will review the research progress and strategies of delaying and reversing endocrine therapy.
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Key words:
- Breast cancer /
- Endocrine therapy /
- Drug resistance /
- Reversal
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表 1 HR+乳腺癌的内分泌联合治疗
Table 1. Endocrine combined therapy for HR + breast cancer
药物类别/靶点 药物名称 临床研究 研究设计 无进展生存时间/月 EGFR inhibitors Gefitinib NCT00229697[2] Tamoxifen + Gefitinib vs placebo 10.9 vs 8.8 NCT00057941[5] Gefitinib + Anastrozole vs
Gefitinib + Fulvestrant5.3 vs 5.2 Molecular targeted agents Trastuzumab TAnDEM-3[3] Trastuzumab + Anastrozole vs anastrozole 4.8 vs 2.4
5.6 vs 3.8Margetuximab SOPHIA-3[4] Margetuximab + chemotherapy vs
Trastuzumab+ chemotherapy6.9 vs 5.1 CDK4/6 inhibitors Abemaciclib MONARCH-3[7] Abemaciclib/placebo+
non-steroidal drugs28.18 vs 14.76 palbociclib NCT02549430[8] Palbociclib + ET vs palbociclib 10.8 vs 6.5 Ribociclib MalAlESA-2[9] Ribociclib + Letrozole vs
ribociclib + placebo25.3 vs 16.0 PI3K/AKT/mTOR inhibitors buparlisib BELLE-2[10] Buparlisib + Fulvestrant vs placebo 6.9 vs 5.0;
6.8 vs 4.5;
6.8 vs 4.0Pictilisib NCT01437566[11] Pictilisib + Fulvestrant vs placebo 6.5 vs 5.1 Alpelisib BYL719-1b[12] Alpelisib + Letrozole vs placebo -N/A MK-2206 NCT01344031[14] MK-2206 + Fulvestrant vs placebo N/A- -
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