Professor and Consultant Oncologist, Section of Oncology, Institute of Medicine, University of Bergen; Department of Oncology, Haukeland University Hospital, N-5021, Bergen, Norway.
Ther Adv Med Oncol. 2012 May;4(3):127-37. doi: 10.1177/1758834012439338.
Use of chemotherapy for patients with estrogen receptor (ER)-positive breast cancer has been a conflicting issue. Recent studies have identified predictive markers allowing identification of poor-prognosis ER-positive breast cancers in need of more aggressive therapy. In general, tumours belonging to the so-called luminal B class, tumours expressing a high Ki67, human epidermal growth factor receptor 2 (HER-2) overexpression or a high score on the Oncotype DX gene expression profile reveal a poor prognosis compared with ER-rich tumours of the luminal A class. In contrast, recent studies have shown these tumours, contrasting tumours of the luminal A class, to benefit from more aggressive anthracycline-containing chemotherapy including a taxane. In the case of metastatic disease, patients with HER-2-positive, ER-positive tumours may benefit from having endocrine therapy and an anti-HER-2 agent administered in combination.
对于雌激素受体 (ER) 阳性乳腺癌患者使用化疗一直是一个有争议的问题。最近的研究已经确定了预测标志物，可以识别需要更积极治疗的预后不良的 ER 阳性乳腺癌。一般来说，属于所谓的 luminal B 类的肿瘤、表达高 Ki67、人表皮生长因子受体 2 (HER-2) 过表达或 Oncotype DX 基因表达谱评分较高的肿瘤与 luminal A 类富含 ER 的肿瘤相比预后较差。相比之下，最近的研究表明，与 luminal A 类肿瘤相反，这些肿瘤受益于更积极的含蒽环类化疗，包括紫杉烷。对于转移性疾病，HER-2 阳性、ER 阳性肿瘤患者可能受益于内分泌治疗和联合使用抗 HER-2 药物。
