Dana Farber Cancer Institute, Harvard University, Boston, MA.
University of California San Diego, San Diego, CA.
Am Soc Clin Oncol Educ Book. 2024 Jun 1;44(3):e432442. doi: 10.1200/EDBK_432442.
Therapeutic advances in breast cancer have significantly improved outcomes in recent decades. In the early setting, there has been a gradual shift from adjuvant-only to neoadjuvant strategies, with a growing focus on customizing post-neoadjuvant treatments through escalation and de-escalation based on pathologic response. At the same time, the transition from a pre-genomic to a post-genomic era, utilizing specific assays in the adjuvant setting and targeted sequencing in the advanced stage, has deepened our understanding of disease biology and aided in identifying molecular markers associated with treatment benefit. Finally, the introduction of new drug classes such as antibody-drug conjugates, and the incorporation in the (neo)adjuvant setting of therapies previously investigated in the advanced stage, like immunotherapy and CDK4-6 inhibitors, poses new challenges in treatment sequencing.
近年来，乳腺癌的治疗进展显著改善了患者的预后。在早期治疗中，已逐渐从辅助治疗策略转向新辅助治疗策略，越来越注重根据病理反应通过升级和降级来定制新辅助治疗方案。与此同时，从基因组前时代向基因组后时代的转变，在辅助治疗中利用特定的检测方法，在晚期阶段进行靶向测序，加深了我们对疾病生物学的理解，并有助于确定与治疗获益相关的分子标志物。最后，新型药物类别的引入，如抗体药物偶联物，以及将以前在晚期阶段研究的治疗方法（如新辅助治疗）纳入治疗方案，如免疫疗法和 CDK4-6 抑制剂，在治疗方案的选择上带来了新的挑战。
