[SABCS2014]SOFT试验:乳腺癌内分泌治疗及卵巢功能抑制——Nancy E. Davidson访谈

作者:  N.E.Davidson   日期:2014/12/16 19:37:41  浏览量:69228

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Davidson教授:SOFT试验与TEXT试验均研究了激素受体(HR)阳性绝经前乳腺癌的最佳内分泌治疗,对单用他莫昔芬(TAM)与卵巢功能抑制(OFS)联合他莫昔芬(TAM)给药,及单用芳香化酶抑制剂(AI)与卵巢功能抑制(OFS)联合芳香化酶抑制剂(AI)给药的治疗策略进行比较。

  Oncology Frontier: Taking those factors into consideration, the clinical doctors examining all those factors, what tips the scale in one way or the other?

  《肿瘤瞭望》:临床医师如何确定哪些患者适合卵巢抑制治疗。

  Dr. Davidson : I think that things that might drive me to think very hard about ovarian function suppression with some kind of oral therapy are first very young patients, patients under the age of 35 look like they benefit from this. Second, women who have a high risk profile, for example multiple positive lymph nodes, might be women who also would be very much served by this and of course this all pertains only to women who are not made post-menopausal by the use of chemotherapy if chemotherapy has been employed.

  Davidson教授:我首先想到口服药物来抑制卵巢功能适合非常年轻的患者,年龄小于35岁的患者似乎可从卵巢功能抑制中获益。其次,高危患者(如多个淋巴结阳性者)也可能会从中获益。当然前提是这些患者化疗后未绝经(如果患者接受化疗的话)。

  Oncology Frontier:  Lastly, you were speaking about what the future plenary talks will be about endocrine therapy. Could you address that?

  《肿瘤瞭望》能否请您展望一下未来内分泌治疗的前景?

  Dr. Davidson : I think it is a really exciting time because we understand so much about endocrine therapy right now and we also understanding some of our limitations with regard to resistance. There is a lot of work going on right now largely in advanced breast cancer trying to find new strategies to overcome resistance. These include things like understanding the cause of resistance, estrogen receptor mutations, estrogen receptor fusions, understanding alternate pathways which may be important – the use of drugs like everolimus or other PI3 kinase inhibitors. We understand the use of HDAC, histone deacetylase inhibitors which show some promise. I think also the opportunity to follow bio markers and to see whether or not we can use this to help us to schedule or to serially give our therapies.

  Davidson教授:我认为,这是个非常激动人心的时刻,我们已经对内分泌治疗及其不足之处(如内分泌治疗耐药)了解甚多。目前正在进行中的内分泌治疗研究有很多,其中大部分研究关注“如何克服晚期乳腺癌内分泌治疗耐药”,即研究内分泌治疗耐药、雌激素受体突变、雌激素受体融合的原因,探寻一些针对其他重要通路的药物(如依维莫司和PI3K抑制剂)的治疗潜力。目前,我们已经知道组蛋白去乙酰化酶(HDAC)抑制剂治疗前景可观。我认为,我们还可以探寻可预测内分泌治疗效果的生物标志物,以便更好地安排治疗方案或进行序贯治疗。

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