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首页> 外文期刊>Cancer Management and Research >Strategies for Increasing the Effectiveness of Aromatase Inhibitors in Locally Advanced Breast Cancer: An Evidence-Based Review on Current Options
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Strategies for Increasing the Effectiveness of Aromatase Inhibitors in Locally Advanced Breast Cancer: An Evidence-Based Review on Current Options

机译：提高氨基脱杉酶抑制剂在局部晚期乳腺癌中的策略的策略：关于当前选择的基于证据审查

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Neoadjuvant hormonal therapy (NEO-HT) is a possible treatment option for breast cancer (BC) patient with estrogen receptor positive (ER+) and HER2 negative (HER2-) disease. The absence of solid data on the type of drugs to be used and duration of treatment as well as lack of clear evidence of effectiveness of NEO-HT compared to chemotherapy (CT) reserve its use for patients with old age or frail conditions. However, the low pathologic complete response rate (pCR) obtained with tamoxifen or aromatase inhibitors (AIs) alone does not make NEO-HT as a suitable option for the neoadjuvant treatment of HR+ HER2-. The use of the cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitors palbociclib, ribociclib and abemaciclib of the mammalian target of rapamycin (mTOR) inhibitor everolimus and of the phosphoinositide 3 kinase (PI3K) inhibitor taselisib together with endocrine therapy (ET) has become a standard in advanced breast cancer, showing clinical effectiveness and significantly prolonging median progression-free survival compared to ET only. In the early phase disease, the use of ET together with CDK 4/6, mTOR and PI3K inhibitors is still investigational. Data from recent studies are promising even though less impressive than in metastatic setting. In this context, the use of genomic-transcriptomic tools (such as ONCOTYPE, PAM50) and the identification of novel biomarkers (ESR1, PI3Kca, PDGF-R) on tissue or with liquid biopsy could help to select patient prone to respond to endocrine-combined therapy and able to achieve pCR. With our review, we aimed at evaluating the current state of the art in the treatment of locally advanced breast cancer with NEO-HT.
机译：Neoadjuvant荷尔蒙治疗（Neo-HT）是乳腺癌（BC）患者的可能治疗选择，雌激素受体阳性（ER +）和HER2阴性（HER2-）疾病。对待使用的药物类型的缺乏固体数据和治疗持续时间以及与化疗（CT）相比缺乏Neo-HT的有效性证据（CT），其用于患有老年或虚弱条件的患者。然而，单独用三氧肟或芳香酶抑制剂（AIS）获得的低病理完全反应速率（PCR）不会使Neo-HT作为HR + Her2-新辅助治疗的合适选择。使用细胞周期蛋白依赖性激酶4和6（CDK 4/6）抑制剂Palbociclib，核苷酸靶标的哺乳动物（MTOR）抑制剂Everolimus的哺乳动物靶标和磷酸钠3激酶（PI3K）抑制剂与内分泌治疗（ ET）已成为晚期乳腺癌的标准，显示临床效果，与ET相比，临床有效性和显着延长了中位进展生存率。在早期疾病中，使用ET与CDK 4/6，MTOR和PI3K抑制剂仍在研究。最近研究的数据很有希望，尽管比转移性设置更少。在这种情况下，使用基因组 - 转录组工具（例如Oncotype，PAM50）和组织或液体活组织检查的新型生物标志物（ESR1，PI3KCA，PDGF-R）可以帮助选择患者容易响应内分泌 - 组合治疗并能够实现PCR。通过我们的评论，我们旨在评估目前患有Neo-HT的局部晚期乳腺癌的现有技术。

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