Di Leo Angelo, Curigliano Giuseppe, Diéras Véronique, Malorni Luca, Sotiriou Christos, Swanton Charles, Thompson Alastair, Tutt Andrew, Piccart Martine
Sandro Pitigliani Department of Medical Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy.
European Institute of Oncology, Division of Medical Oncology, Milan, Italy.
Breast. 2015 Aug;24(4):321-30. doi: 10.1016/j.breast.2015.03.001. Epub 2015 Mar 31.
Considerable progress has been made in breast cancer treatment in Europe over the past three decades, yet survival rates for metastatic disease remain poor, underlining the need for further advances. While the use of predictive biomarkers for response to systemic therapy could improve drug development efficiency, progress in identifying such markers has been slow. The currently inadequate classification of breast cancer subtypes is a further challenge. Improved understanding of the molecular pathology of the disease has led to the identification of new targets for drug treatment, and evolving classifications should reflect these developments. Further ongoing challenges include difficulties in finding optimal combinations and sequences of systemic therapies, circumventing multidrug resistance and intra-tumor heterogeneity, problems associated with fragmentation in clinical trials and translational research efforts. Adoption of some of the strategies identified in this article may lead to further improvements in outcomes for patients with the disease.
在过去三十年里，欧洲乳腺癌治疗取得了显著进展，但转移性疾病的生存率仍然很低，这凸显了进一步取得进展的必要性。虽然使用预测性生物标志物来评估对全身治疗的反应可以提高药物开发效率，但识别此类标志物的进展一直很缓慢。目前乳腺癌亚型分类不足是另一个挑战。对该疾病分子病理学的深入了解已导致确定了新的药物治疗靶点，不断发展的分类应反映这些进展。其他持续存在的挑战包括难以找到全身治疗的最佳组合和顺序、克服多药耐药性和肿瘤内异质性、与临床试验和转化研究工作碎片化相关的问题。采用本文确定的一些策略可能会进一步改善该疾病患者的治疗结果。
