Washington Cancer Institute, Washington Hospital Center, Washington, District of Columbia 20010, USA.
Oncologist. 2011;16 Suppl 1:30-9. doi: 10.1634/theoncologist.2011-S1-30.
Treatment options for patients with breast cancer have progressively improved over the past 40 years, from an era of no chemotherapy to the introduction of taxanes, hormonal therapy, and biologic therapy. These advances have resulted in substantial, 15%-20% improvements in clinical outcomes. However, progress has yet to be made to improve the prognosis in many breast cancer patients, and research is currently under way to test new tools, or new applications of older tools, to advance breast cancer management. Chemotherapy clearly remains a cornerstone of adjuvant breast cancer treatment, because breast cancer can be very sensitive to the currently available agents. Meanwhile, the era of a one-size-fits-all approach to breast cancer management is over, and the maximum potential of chemotherapy should now be reached by targeting specific populations. Effective biomarkers are therefore needed to optimize chemotherapy, define more selective populations, and clearly tailor treatment. This paper discusses recent data, including new trials that are more fully incorporating current knowledge with respect to molecular markers and the underlying biology of breast cancer.
过去 40 年来，乳腺癌患者的治疗选择逐渐得到改善，从无化疗时代到紫杉烷类药物、激素治疗和生物治疗的引入。这些进展使临床结果有了实质性的、15%-20%的改善。然而，在许多乳腺癌患者的预后方面仍有待取得进展，目前正在研究新的工具或旧工具的新应用，以推进乳腺癌的管理。化疗显然仍然是辅助乳腺癌治疗的基石，因为乳腺癌对目前可用的药物非常敏感。同时，乳腺癌管理一刀切的时代已经结束，现在应该通过针对特定人群来最大限度地发挥化疗的潜力。因此，需要有效的生物标志物来优化化疗，定义更具选择性的人群，并明确调整治疗方案。本文讨论了最近的数据，包括新的试验，这些试验更充分地将当前关于分子标志物和乳腺癌基础生物学的知识纳入其中。
