绝经后受体阳性乳腺癌患者高危人群的内分泌治疗

绝经后激素受体阳性乳腺癌患者高危人群的内分泌治疗,北京大学人民医院王 殊,ER阳性患者预后,EBCTCG，Lancet. 2005,Long-Term Risk of Breast Cancer,Presented By Ian Smith at 2014 ASCO Annual Meeting,Clinical trials,MA17,Anastrozoleletrozoleexemetane,BIG 1-98,ATAC,ABCSG 6a,IES,B 33,ABCSG-8 ARNO95/ITA,TEAM,Upfront switch/sequential extended,MA27,ANA 5Y,EXE 5Y,FACE,ANA 5Y,LET 5Y,Head to head,ATTOM,ATLAS,Tamoxifen,高危人群,肿瘤大小淋巴结转移组织学分级ER/PRHER2Ki67,分子分型 RS ROR,淋巴结转移与生存,Annals of Oncology, 2007,受体阳性乳腺癌患者的生存(SEER Data),0.95,1.00,0.90,0.85,0.80,0.75,0,10,20,30,40,50,60,70,80,Survival (mo),Cumulative proportion surviving,Joint ER/PR Phenotype,ER+PR+ (n=12,811),ER+PR- (n=2,436),ER-PR+ (n=663),Node-negative patientswith T1-T3 tumors,HER2阳性患者预后较差,Tamoxifen,Anastrozole,RFS,RFS,Dowsett,JCO,2008,Ki-67,Pathol Oncol Res.2014,10,21-Gene Recurrence Score Assay forPostmenopausal, ER(+) Breast Cancer,Lancet Oncol. 2010,高危人群 风险控制,AI还是TAM?初始还是序贯？5年还是更长？,高危人群 风险控制,AI还是TAM?初始还是序贯？5年还是更长？,ATAC,BIG1-98,Relationship of ER level and response to ET,高危人群 风险控制,AI还是TAM?初始还是序贯？5年还是更长？,BIG1-98 序贯,高危人群 风险控制,AI还是TAM?初始还是序贯？5年还是更长？,Pooled analysis ATLAS + aTTom:Breast Cancer Mortality,Presented By Ian Smith at 2014 ASCO Annual Meeting,Extended Adjuvant Therapy with AIs,Presented By Ian Smith at 2014 ASCO Annual Meeting,Slide 13,Presented By Ian Smith at 2014 ASCO Annual Meeting,Slide 14,Presented By Ian Smith at 2014 ASCO Annual Meeting,Longer-Term Outcomes of Letrozole v. Placebo After 5Years of Tamoxifen in the MA.17 Trial: Analyses Adjusting for Treatment Crossover,Presented By Ian Smith at 2014 ASCO Annual Meeting,MA17,HR = 0.61，P = .04,Slide 17,Presented By Ian Smith at 2014 ASCO Annual Meeting,Slide 19,Presented By Ian Smith at 2014 ASCO Annual Meeting,Slide 20,Presented By Ian Smith at 2014 ASCO Annual Meeting,Slide 21,Presented By Ian Smith at 2014 ASCO Annual Meeting,How Long Is Long Enough? Defining Optimal Duration and Selection of Adjuvant Endocrine Therapy,Presented By Ian Smith at 2014 ASCO Annual Meeting,ConclusionSo What do We Do As Clinicians?,Presented By Ian Smith at 2014 ASCO Annual Meeting,副作用-ATAC,副作用 BIG1-98,副作用-IES,Value-Based Approach to Systemic Therapy in Patients with Breast Cancer: What is the Evidence?,Presented By Michael Hassett at 2014 ASCO Annual Meeting,What do we get for what we spend?,Presented By Michael Hassett at 2014 ASCO Annual Meeting,Value?,Presented By Michael Hassett at 2014 ASCO Annual Meeting,Valuable treatments should produce