非转移性乳腺癌的辅助性内分泌治疗策略:一个网络的元分析
Andri Papakonstantinou1,2, Guillermo Villacampa3,4, Victor Navarro4
1Oncology/Pathology Department, Karolinska Institutet, Stockholm, Sweden.
EClinicalMedicine
|March 4, 2025
概括
早期乳腺癌的最佳内分泌疗法因更年期状态而异. 卵巢功能抑制加上芳酶抑制剂对更年期前妇女是最好的,而芳酶抑制剂或切换疗法对更年期后妇女有益,改善无疾病生存率.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 临床试验 临床试验
背景情况:
- 早期乳腺癌治疗包括内分泌疗法升级策略.
- 绝经前的患者可能会从卵巢功能抑制 (OFS) 和芳酶抑制剂 (AI) 中受益.
- 由于研究异质性,关于最佳策略存在争议.
研究的目的:
- 研究激素受体阳性早期乳腺癌的最佳内分泌治疗策略.
- 为了比较不同的内分泌治疗升级和延伸策略.
- 为临床实践提供基于证据的建议.
主要方法:
- 随机对照试验 (RCT) 的系统文献搜索更新:2024年8月.
- 使用频率主义框架和随机效应模型进行网络元分析.
- 单个患者数据的元分析以估计绝对治疗差异.
主要成果:
- 包括37个RCT,包括107,684名患者.
- 在绝经前妇女中最有效的OFS + AI;在绝经后妇女中最有效的AI或切换策略 (前五年).
- 在他莫西芬或AI/switch后延长AI改善了8年无病生存期 (DFS).
结论:
- 卵巢功能抑制加上芳酶抑制剂是绝经前妇女的最佳选择.
- 芳酶抑制剂或切换策略对绝经后妇女有效.
- 延长内分泌疗法,特别是人工智能,可以改善早期乳腺癌的DFS.
相关概念视频
Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
Treatment Resistant Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Cancer Survival Analysis
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...


