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Late Recurrences in early breast cancer: For whom and how long is endocrine therapy beneficial?

机译：早期乳腺癌的晚期复发：内分泌治疗对谁有益？

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During the last decade, besides the well-established clinical-pathological predictors for the risk of late recurrence in breast cancer, such as estrogen receptor status, and T and N stage, a variety of multigene assays have been shown to improve prognostication and prediction in this setting. Several clinical trials have evaluated the role of extended endocrine therapy with tamoxifen (ATLAS) or aromatase inhibitors (MA.17, NSABP-B33 and ABCSG 6a), and other randomized studies are still ongoing. However, among this patient population, it is still not clear who could benefit from extended therapy and what the optimal treatment duration should be. New multigene assays such as EndoPredict, PAM50 ROR-score, HOXB13/IL17BR ratio and Breast Cancer Index provide significant and relevant prognostic information concerning the likelihood of recurrence beyond 5 years after surgery. The identified low-risk subgroups not only show a very favorable prognosis, they also seem to have only little benefit from extended aromatase inhibitor therapy. Many of these reverse transcriptase/polymerase chain reaction-based techniques have been validated in archived tumor material from large phase III trials, and will soon be available to routine pathology laboratories as an aid in clinical decision-making for patients.
机译：在过去的十年中，除了针对乳腺癌晚期复发风险的公认的临床病理学预测因子（如雌激素受体状态，T和N期）外，多种多基因检测方法还被证明可以改善预后和预测此设置。几项临床试验评估了他莫昔芬（ATLAS）或芳香酶抑制剂（MA.17，NSABP-B33和ABCSG 6a）的扩大内分泌治疗的作用，其他随机研究仍在进行中。但是，在这一患者人群中，尚不清楚谁可以从延长治疗中受益，以及最佳治疗时间应为多少。诸如EndoPredict，PAM50 ROR评分，HOXB13 / IL17BR比和乳腺癌指数等新的多基因检测方法可提供有关术后5年以上复发可能性的重要且相关的预后信息。确定的低风险亚组不仅显示出非常好的预后，而且似乎也无法从延长的芳香化酶抑制剂治疗中获益。许多基于逆转录酶/聚合酶链反应的技术已在大型III期试验的已存档肿瘤材料中得到验证，并将很快用于常规病理学实验室，以帮助患者进行临床决策。

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