通过乳腺癌指数评估辅助内分泌疗法与卵巢功能抑制
Ruth M O'Regan1, Yue Ren2, Yi Zhang3
1Department of Medicine, University of Rochester, Rochester, New York.
JAMA network open
|November 3, 2025
概括
乳腺癌指数 (BCI) 并不能清楚地预测哪些患有激素受体阳性乳腺癌的绝经前妇女从埃克塞梅斯坦加卵巢功能抑制 (OFS) 中受益最多. BCI持续预测了绝经前妇女的远程复发风险.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 内分泌学 在内分泌学.
背景情况:
- 乳腺癌指数 (BCI) 之前已经确定了患有BCI[H/I]低瘤的绝经前患者,他们最有可能从包含卵巢功能抑制 (OFS) 的辅助疗法中受益.
- 评估BCI在接受特定辅助疗法的绝经前妇女的预测和预后价值对于个性化治疗策略至关重要.
研究的目的:
- 为了评估BCI作为治疗效益的预测生物标志物,使用埃克塞梅斯坦加OFS与他莫西芬加OFS.
- 为了验证BCI作为预后生物标志物,为绝经前的患者与激素受体阳性乳腺癌.
主要方法:
- 在Tamoxifen和Exemestane (TEXT) 试验和抑制卵巢功能试验 (SOFT) 试验中的前性-后性翻译研究.
- 包括患有激素受体阳性乳腺癌的绝经前妇女,随机分配给他莫西芬加OFS或埃克塞梅斯坦加OFS.
- 经过13年的中位随访后,分析了乳腺癌无间隔 (BCFI) 和远程无复发间隔 (DRFI).
主要成果:
- BCI [H/I] 状态并没有清楚地预测,在BCI [H/I] 较低的瘤中,exemestane加OFS与tamoxifen加OFS对BCI [H/I] 较低的瘤有更大的益处.
- 重新确认BCI连续指数作为绝经前妇女远期复发的预后 (N0和N1疾病).
- 患有BCI[H/I]低瘤的患者在12年的BCFI中表现出6.6%的绝对益处,用于埃克塞梅斯坦加上OFS与坦莫西芬加上OFS.
结论:
- BCI [H/I] 状态并没有明确预测在绝经前乳腺癌中,埃克塞梅斯坦加OFS和他莫西芬加OFS之间的差异效益.
- 对于绝经前妇女来说,BCI连续指数仍然是有价值的预后标记.
- 结果表明,患有BCI[H/I]低瘤的绝经前患者可能会从更密集的内分泌治疗中受益,这支持了之前的SOFT试验结果.
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