Köberle Dieter, Thürlimann Beat
Department of Oncology/Hematology, Kantonsspital St. Gallen, CH 9007 St. Gallen, Switzerland.
Breast. 2005 Dec;14(6):446-51. doi: 10.1016/j.breast.2005.08.003. Epub 2005 Sep 16.
Tamoxifen has been the endocrine agent of choice for adjuvant hormonal therapy for early breast cancer since approval in 1986. Five years of tamoxifen treatment produced a significant reduction in recurrence and death over more than 10 years of follow-up in women with estrogen receptor-positive (ER+) breast cancer. In large randomised trials, the standard of 5 years tamoxifen has been challenged by third-generation aromatase inhibitors (AIs) in the adjuvant setting. This review provides a synopsis of the most recent trial results and a discussion of remaining areas of uncertainties. Although currently tamoxifen still remains a valid option, increasing evidence from the new AI adjuvant trials suggests that optimised adjuvant endocrine treatment should incorporate an AI either as initial or as sequential therapy.
自1986年获批以来，他莫昔芬一直是早期乳腺癌辅助激素治疗的首选内分泌药物。在雌激素受体阳性（ER+）乳腺癌女性患者超过10年的随访中，5年他莫昔芬治疗显著降低了复发率和死亡率。在大型随机试验中，辅助治疗中5年他莫昔芬的标准受到了第三代芳香化酶抑制剂（AI）的挑战。本综述概述了最新试验结果，并讨论了仍存在不确定性的领域。尽管目前他莫昔芬仍是一个有效的选择，但来自新的AI辅助试验的越来越多的证据表明，优化的辅助内分泌治疗应将AI作为初始治疗或序贯治疗。
