HR+HER2-晚期乳腺癌内分泌治疗临床应用的研究进展

doi:10.13481/j.1671-587x.20190347

摘要/Abstract

摘要： 晚期乳腺癌目前难以治愈，是导致乳腺癌患者死亡的主要原因。内分泌治疗具有不良反应少、给药方式简单和延长患者生存期的优点，是无内脏危象的绝经后激素受体（HR）阳性且人类表皮生长因子受体2（HER2）阴性（HR+HER2-）晚期乳腺癌患者的首选治疗方式，其治疗药物主要包括他莫昔芬（TAM）、芳香化酶抑制剂（AI）和氟维司群。随着对乳腺癌耐药机制的深入研究，众多克服内分泌耐药的药物相继问世，如CDK4/6抑制剂和mTOR抑制剂，使内分泌治疗药物的选择不断优化。本文对晚期乳腺癌内分泌治疗药物的临床研究进行综述。对于HR+HER2-晚期乳腺癌患者，一线内分泌治疗药物的疗效：氟维司群>AI>TAM；内分泌治疗耐药者可选择内分泌治疗联合CDK4/6抑制剂或mTOR抑制剂，如CDK4/6抑制剂+AI、CDK4/6抑制剂+氟维司群、mTOR抑制剂+TAM、mTOR抑制剂+AI、mTOR抑制剂+氟维司群。具体药物选择需对患者的既往用药情况、肿瘤负荷、疾病进展速度和经济情况进行综合考量。对于一线化疗获益患者，维持治疗可延长患者的无进展生存期（PFS）及总生存期（OS）。本文系统地总结了国内外相关临床研究的结论，探讨HR+HER2-晚期乳腺癌患者内分泌治疗的疗效以及一线化疗后维持治疗使患者获益的情况，以期提高HR+HER2-晚期乳腺癌患者的预后生存质量。

关键词: 乳腺肿瘤, 内分泌治疗, 维持治疗, 他莫昔芬, 芳香化酶抑制剂, 氟维司群

中图分类号:

R730.5

李贝贝, 杨婷婷, 关萌, 王磊, 王爽, 康丽花, 宋艳秋. HR+HER2-晚期乳腺癌内分泌治疗临床应用的研究进展[J]. 吉林大学学报(医学版), 2019, 45(03): 736-741.

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