文章：

早期乳腺癌患者延长辅助内分泌治疗——综述与展望

Extended Adjuvant Endocrine Therapy in Early Breast Cancer Patients—Review and Perspectives

原文发布日期：21 August 2023

DOI: 10.3390/cancers15164190

类型: Article

开放获取: 是

英文摘要：

Seventy percent of all breast cancer subtypes are hormone receptor-positive. Adjuvant endocrine therapy in these patients plays a key role. Despite the traditional duration of a 5-year intake, the risk of relapse remains elevated in a substantial proportion of patients. Several trials report that the risk of late recurrence is reduced by the extension of adjuvant endocrine therapy beyond 5 years. However, the optimal duration of endocrine therapy is still a matter of debate. The newer data only show a marginal benefit resulting from extension beyond 7 to 10 years. Furthermore, extension may be associated with more side effects. Thus, the adequate selection of patients qualifying for an extended adjuvant therapy is of importance. Tools/genomic tests, which include the characteristics of the patient and the tumor, may help to better identify patients with a risk of a late relapse. Taken together, the magnitude of benefit for extended adjuvant endocrine therapy is based on the precise estimation of the risk of relapse after 5 years. This must be balanced against the long-term side effects of endocrine treatment and the competing risks. For patients with an intermediate risk, 7 years appears to be the optimal duration, and in those with high-risk features, endocrine therapy up to 10 years may be considered.

摘要翻译： 

在所有乳腺癌亚型中，激素受体阳性占比达70%。针对此类患者的辅助内分泌治疗具有关键作用。尽管传统疗程为5年，但仍有相当比例患者的复发风险持续偏高。多项临床试验表明，将辅助内分泌治疗延长至5年以上可降低晚期复发风险。然而，内分泌治疗的最佳持续时间仍存在争议。最新数据显示，延长治疗至7-10年带来的获益较为有限，且可能伴随更多副作用。因此，精准筛选适合延长辅助治疗的患者至关重要。结合患者与肿瘤特征的检测工具/基因组测试，有助于更准确识别晚期复发高风险人群。总体而言，延长辅助内分泌治疗的获益程度取决于对5年后复发风险的精确评估，这需要与内分泌治疗的长期副作用及竞争风险进行权衡。对于中危患者，7年疗程似为最佳选择；而具有高危特征的患者，可考虑将内分泌治疗延长至10年。

原文链接：

Extended Adjuvant Endocrine Therapy in Early Breast Cancer Patients—Review and Perspectives