Domont Julien, Namer Moise, Khayat David, Spano Jean-Philippe
Institut Curie, Département de radiothérapie, Paris, France.
Bull Cancer. 2004 Jan;91(1):55-62.
The clinical benefits of endocrine therapy for patients with hormonosensitive breast cancer remains perfectly established. For instance, tamoxifen, the gold standard of the adjuvant treatment, has largely contributed of the effectiveness of such a therapy. The recent development of new endocrine agents (the third-generation aromatase inhibitors, selective estrogen receptors modulators), provides to physicians the opportunity of a more effective and tolerable therapeutic approach, in the metastatic disease setting or likely in adjuvant setting for breast cancer patients. Preoperative therapy has been widely used for the treatment of initially inoperable locally advanced breast cancers with the main objective of breast-conserving surgery. The benefits of neoadjuvant chemotherapy has widely been demonstrated; however, the success of neoadjuvant endocrine therapy is much recent. The clinical and pharmacological data of the main published studies using neoadjuvant hormonotherapy are presented herein this review. Therefore, clinical and histologic assessments of response brings essential informations about the breast cancer hormonal sensitivity, but may also be predictor of the future (adjuvant or metastatic) treatment responsiveness.
内分泌治疗对激素敏感性乳腺癌患者的临床益处已得到充分证实。例如,辅助治疗的金标准他莫昔芬对这种治疗的有效性有很大贡献。新型内分泌药物(第三代芳香化酶抑制剂、选择性雌激素受体调节剂)的最新进展为医生提供了在转移性疾病情况下或可能在乳腺癌患者辅助治疗中采用更有效且耐受性更好的治疗方法的机会。术前治疗已广泛用于治疗最初无法手术的局部晚期乳腺癌,主要目的是保乳手术。新辅助化疗的益处已得到广泛证实;然而,新辅助内分泌治疗的成功是最近才有的。本综述介绍了使用新辅助激素治疗的主要已发表研究的临床和药理学数据。因此,对反应的临床和组织学评估不仅能提供有关乳腺癌激素敏感性的重要信息,还可能是未来(辅助或转移性)治疗反应性的预测指标。