Arthur Laura M, Turnbull Arran K, Khan Lucy R, Dixon J Michael
Edinburgh Breast Cancer Now Research Team, Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, Western General Hospital, The University of Edinburgh, Crewe Road South, Edinburgh, EH4 2XU Scotland.
Edinburgh Breast Unit, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU Scotland.
Curr Breast Cancer Rep. 2017;9(4):202-209. doi: 10.1007/s12609-017-0255-6. Epub 2017 Oct 27.
Pre-operative endocrine therapy can be used to down-stage large or locally advanced breast cancers in ER+ disease. In the last four decades, it has evolved from a treatment perceived as an alternative to surgery for those too unfit to undergo surgery or chemotherapy, to the present day where it is a valuable and valid option in the treatment of postmenopausal women with ER-rich (Allred score 7-8, or > 50% staining for ER) breast cancer.
Emerging data from the metastatic setting is translating into neoadjuvant trials, utilising dual endocrine targeting or combinations of endocrine agents and other targeted drugs, including those acting against components of the PI3K pathway and the cell cycle. The routine use of peri-operative endocrine therapy in all ER+ tumours may help to yield important long-term prognostic information, and guide adjuvant endocrine therapy.
Pre-operative endocrine therapy is an exciting and evolving area with emerging new approaches. In this review, established evidence and emerging data on its applications are discussed.
术前内分泌治疗可用于使雌激素受体（ER）阳性的大型或局部晚期乳腺癌降期。在过去的四十年里，它已从一种被视为不适于接受手术或化疗者的手术替代治疗方法，发展到如今成为治疗雌激素受体丰富（阿尔雷德评分7 - 8分，或雌激素受体染色>50%）的绝经后女性乳腺癌的一种有价值且有效的选择。
来自转移性疾病背景的新数据正在转化为新辅助治疗试验，采用双重内分泌靶向治疗或内分泌药物与其他靶向药物联合使用，包括作用于PI3K通路和细胞周期成分的药物。在所有雌激素受体阳性肿瘤中常规使用围手术期内分泌治疗可能有助于获得重要的长期预后信息，并指导辅助内分泌治疗。
术前内分泌治疗是一个令人兴奋且不断发展的领域，有新的方法不断涌现。在本综述中，将讨论其应用的既有证据和新出现的数据。
