Lousberg Laurence, Jerusalem Guy
Medical Oncology, CHU Sart Tilman Liege, Liege, Belgium.
Medical Oncology, CHU Sart Tilman Liege, Liege, Belgium.; Liege University, Liege, Belgium.
Breast Cancer (Auckl). 2017 Jan 4;10:239-252. doi: 10.4137/BCBCR.S12443. eCollection 2016.
Everolimus combined with exemestane is an important treatment option for patients suffering from estrogen receptor-positive, human epidermal growth factor receptor 2-negative, advanced breast cancer (ABC) who have been previously treated with a nonsteroidal aromatase inhibitor (NSAI). After presentation of phase III registration trial BOLERO-2, several phase IIIb trials have been started to evaluate this regimen in a more real-world setting. Here, we review the efficacy and safety data published or presented at selected international meetings. These studies confirmed the outcome observed in the BOLERO-2 trial. Patient acceptance rate is also discussed by focusing on the permanent everolimus discontinuation rate in these trials. Factors influencing the safety profile are also reported, including the impact of age. The optimal sequence of combined therapy approaches associating targeted and endocrine therapy (ET) has yet to be determined as new treatment options such as cyclin-dependent kinase inhibitors become available. However, everolimus-exemestane remains an important treatment option with a major impact on progression-free survival (PFS) and an acceptable safety profile.
依维莫司联合依西美坦是雌激素受体阳性、人表皮生长因子受体2阴性的晚期乳腺癌(ABC)患者的重要治疗选择,这些患者此前已接受过非甾体芳香化酶抑制剂(NSAI)治疗。在公布III期注册试验BOLERO-2的结果后,已启动了多项IIIb期试验,以在更贴近现实的环境中评估该治疗方案。在此,我们回顾在选定国际会议上发表或展示的疗效和安全性数据。这些研究证实了BOLERO-2试验中观察到的结果。还通过关注这些试验中依维莫司的永久停药率来讨论患者接受率。还报告了影响安全性的因素,包括年龄的影响。随着细胞周期蛋白依赖性激酶抑制剂等新治疗选择的出现,联合靶向治疗和内分泌治疗(ET)的最佳治疗顺序尚待确定。然而,依维莫司-依西美坦仍然是一种重要的治疗选择,对无进展生存期(PFS)有重大影响,且安全性可接受。