Hu Mengyu, Shao Bin, Ran Ran, Li Huiping
Radiation Oncology Center, Chongqing University Cancer Hospital, Chongqing, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
Transl Cancer Res. 2021 Apr;10(4):1644-1655. doi: 10.21037/tcr-20-2119.
To treat metastatic breast cancer (MBC) more precisely, many efforts have been made to identify prognostic factors of MBC in many studies. This review aims to qualitatively summarize these studies and to provide a reference for the research of MBC.
Relevant papers were searched on PubMed, with the search terms including MBC, prognostic factors and prognosis, and the studies aimed at exploring prognostic factors for patients with histologically confirmed MBC, including stage IV at initial diagnosis and metastatic recurrence, were included.
A total of 30 papers were included at last. An analysis of prognostic factors frome those studies was conducted. Age at primary diagnosis (6 studies), performance status (4 studies), histological grade (4 studies), hormonal receptor (HR) status (9 studies) and site of metastasis (12 studies) were universally acknowledged prognostic factors. There were four studies revealing that short DFS was significantly associated with better OS, while there was one study not revealing this association. There were various results in different studies with a reference to efficacy. Surgery and endocrine therapy were related to a better prognosis (3 studies). Targeted therapies could also conduce to the prognosis. However, there was still a contention on the role of radiotherapy. In particular, a model was brought out to calculate the risk of death in MBC. Meanwhile, it was found that some biomarkers are related to prognosis as well as per the latest findings in some studies.
In summary, intrinsic characteristics of tumors such as HR status and histological grade are the main factors affecting the prognosis of patients with MBC. Besides traditional factors, some new drugs and biomarkers are also associated with the prognosis of patients with MBC. In the future, the focus of studies shall be on the construction of a practical and high-quality model to predict the risk of death in MBC patients.
为了更精准地治疗转移性乳腺癌(MBC),许多研究致力于确定MBC的预后因素。本综述旨在对这些研究进行定性总结,为MBC的研究提供参考。
在PubMed上检索相关论文,检索词包括MBC、预后因素和预后,纳入旨在探索组织学确诊的MBC患者预后因素的研究,包括初诊时IV期及转移复发情况。
最终共纳入30篇论文。对这些研究中的预后因素进行了分析。初诊年龄(6项研究)、体能状态(4项研究)、组织学分级(4项研究)、激素受体(HR)状态(9项研究)和转移部位(12项研究)是公认的预后因素。有4项研究表明无病生存期短与总生存期较好显著相关,而有1项研究未显示这种关联。不同研究在疗效方面有各种结果。手术和内分泌治疗与较好的预后相关(3项研究)。靶向治疗也有助于改善预后。然而,放疗的作用仍存在争议。特别是,提出了一个模型来计算MBC患者的死亡风险。同时,根据一些研究的最新发现,发现一些生物标志物也与预后相关。
总之,HR状态和组织学分级等肿瘤内在特征是影响MBC患者预后的主要因素。除传统因素外,一些新药和生物标志物也与MBC患者的预后相关。未来,研究重点应放在构建实用且高质量的模型以预测MBC患者的死亡风险上。