Solid Tumor Division, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Clin Breast Cancer. 2010 Sep;10 Suppl 2:S41-9. doi: 10.3816/CBC.2010.s.011.
Breast cancer is a common public health problem, and the most important prognostic factors in survival or recurrence after potentially curative surgery include the number of involved axillary lymph nodes and the biology of the disease. Systemic chemotherapy remains a critical component in the eradication of occult micrometastatic disease in the adjuvant setting. The 2000 Early Breast Cancer Trialists' Collaborative Group overview of polychemotherapy in breast cancer has demonstrated that anthracycline-based regimens are superior to non-anthracycline-based therapies in terms of disease-free survival and overall survival. The taxanes paclitaxel and docetaxel were well established in metastatic breast cancer and lack cross-resistance with anthracyclines and were therefore quickly deemed worthwhile for evaluation in the adjuvant setting. A large meta-analysis showed that the addition of a taxane to an anthracycline-based regimen improves outcomes in high-risk patients regardless of age, menopausal status, number of nodes involved, hormone receptor status, and type of taxane. There are several effective anthracycline/taxane combinations traditionally studied in patients with high-risk disease. In this overview, we will review some of the key trials that have advanced the standard of care in the adjuvant setting with regard to various chemotherapy combinations.
乳腺癌是一个常见的公共健康问题，在潜在可治愈的手术后生存或复发的最重要预后因素包括腋窝淋巴结受累的数量和疾病的生物学特性。全身化疗仍然是辅助治疗中消除隐匿性微转移疾病的关键组成部分。2000 年早期乳腺癌试验者协作组对乳腺癌的化疗综述表明，基于蒽环类药物的方案在无病生存率和总生存率方面优于非蒽环类药物疗法。紫杉烷类药物紫杉醇和多西他赛在转移性乳腺癌中已经得到很好的应用，并且与蒽环类药物没有交叉耐药性，因此很快被认为值得在辅助治疗中进行评估。一项大型荟萃分析表明，在高危患者中，无论年龄、绝经状态、淋巴结受累数量、激素受体状态和紫杉烷类型如何，在蒽环类药物基础方案中添加紫杉烷可改善结局。传统上，高危疾病患者中研究了几种有效的蒽环类/紫杉烷联合方案。在这篇综述中，我们将回顾一些关键的临床试验，这些试验在辅助治疗中针对各种化疗联合方案推进了标准治疗。
