Hortobagyi G N
Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Breast Cancer Res Treat. 1992;21(1):3-13. doi: 10.1007/BF01811959.
Progress in the treatment of breast cancer developed along multiple directions of research during the last decade. The concept of dose-intensity was addressed through retrospective analyses and prospective randomized trials. It was confirmed that dose-intensity correlates with higher response rates, but the effect of dose-intensive treatments on survival still needs to be established. Several new cytotoxic drugs have appeared during the last several years. Taxol, navelbine, and anthrapyrazole CI-941 have been found to have major efficacy against breast cancer, with response rates exceeding 50%. Amonafide, lonidamine, and elliptinium analogs were also shown to be effective, although to a lesser degree. Antiestrogen analogs, new aromatase inhibitors, and LHRH analogs are recent developments that are changing the face of hormonal therapy. Monoclonal antibodies are being developed and evaluated for tumor imaging applications and as vehicles for specific antitumor agents (cytotoxics, radioisotopes, and toxins). Expanding knowledge about the basic biology of breast cancer has led to the identification of growth factors and their receptors, which may be exploited for therapeutic purposes in the not too distant future.
在过去十年中,乳腺癌治疗沿着多个研究方向取得了进展。通过回顾性分析和前瞻性随机试验探讨了剂量强度的概念。已证实剂量强度与更高的缓解率相关,但剂量密集型治疗对生存的影响仍有待确定。在过去几年中出现了几种新的细胞毒性药物。已发现紫杉醇、诺维本和蒽吡唑CI-941对乳腺癌具有主要疗效,缓解率超过50%。氨茴苯酸、氯尼达明和椭圆玫瑰树碱类似物也显示有效,尽管程度较小。抗雌激素类似物、新型芳香化酶抑制剂和促黄体生成素释放激素类似物是正在改变激素治疗面貌的最新进展。正在开发和评估单克隆抗体用于肿瘤成像应用以及作为特定抗肿瘤药物(细胞毒性药物、放射性同位素和毒素)的载体。对乳腺癌基础生物学知识的不断扩展已导致生长因子及其受体的鉴定,在不久的将来可能会将其用于治疗目的。