Figg William D, Cook Katherine, Clarke Robert
a Trinity College Dublin ; University of Dublin ; Dublin , Ireland.
Cancer Biol Ther. 2014;15(12):1586-7. doi: 10.4161/15384047.2014.972783.
The goal of adjuvant hormonal therapy for breast cancer is to prevent recurrence by eradicating micrometastatic disease. Recent studies have shown that the use of aromatase inhibitors (AIs) as adjuvant therapy improves outcomes for postmenopausal women with estrogen receptor (ER)-positive breast cancer compared to adjuvant endocrine therapy with tamoxifen alone. The research question has been raised whether AIs would have similar improvements in disease-free survival (DFS) in premenopausal women with ER-positive breast cancer. Combining 2 phase 3 clinical trials (n = 4,690), Pagani and colleagues randomized premenopausal women with ER-positive early breast cancer to exemestane plus ovarian suppression or tamoxifen plus ovarian suppression for a period of 5 y. After a median follow-up of 68 months, DFS was 91.1% in the AI group and 87.3% in the tamoxifen group. In premenopausal women with hormone-receptor-positive early breast cancer, adjuvant treatment with exemestane plus ovarian suppression, as compared with tamoxifen plus ovarian suppression, significantly reduced recurrence.
乳腺癌辅助激素治疗的目标是通过根除微转移病灶来预防复发。最近的研究表明，与单独使用他莫昔芬进行辅助内分泌治疗相比，使用芳香化酶抑制剂（AI）作为辅助治疗可改善绝经后雌激素受体（ER）阳性乳腺癌女性的预后。对于ER阳性的绝经前乳腺癌女性，AI在无病生存期（DFS）方面是否会有类似的改善这一研究问题已被提出。Pagani及其同事将两项3期临床试验（n = 4,690）相结合，将ER阳性早期乳腺癌的绝经前女性随机分为依西美坦加卵巢抑制组或他莫昔芬加卵巢抑制组，为期5年。在中位随访68个月后，AI组的DFS为91.1%，他莫昔芬组为87.3%。在激素受体阳性的早期乳腺癌绝经前女性中，与他莫昔芬加卵巢抑制相比，依西美坦加卵巢抑制的辅助治疗显著降低了复发率。
