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-TermRiskofBreastCancer,PresentedByIanSmithat2014ASCOAnnualMeeting,Clinicaltrials,MA17,Anastrozoleletrozoleexemetane,BIG1-98,ATAC,ABCSG6a,IES,B33,ABCSG-8ARNO95/ITA,TEAM,Upfrontswitch/sequentialextended,MA27,ANA5Y,EXE5Y,FACE,ANA5Y,LET5Y,Headtohead,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RSROR,淋巴结转移与生存,AnnalsofOncology,2007,受体阳性乳腺癌患者的生存(SEERData),0.95,1.00,0.90,0.85,0.80,0.75,0,10,20,30,40,50,60,70,80,Survival(mo),Cumulativeproportionsurviving,JointER/PRPhenotype,ER+PR+(n=12,811),ER+PR-(n=2,436),ER-PR+(n=663),Node-negativepatientswithT1-T3tumors,HER2阳性患者预后较差,Tamoxifen,Anastrozole,RFS,RFS,Dowsett,JCO,2008,Ki-67,PatholOncolRes.2014,10,21-GeneRecurrenceScoreAssayforPostmenopausal,ER(+)BreastCancer,LancetOncol.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,RelationshipofERlevelandresponsetoET,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？,PooledanalysisATLAS+aTTom:BreastCancerMortality,PresentedByIanSmithat2014ASCOAnnualMeeting,ExtendedAdjuvantTherapywithAIs,PresentedByIanSmithat2014ASCOAnnualMeeting,Slide13,PresentedByIanSmithat2014ASCOAnnualMeeting,Slide14,PresentedByIanSmithat2014ASCOAnnualMeeting,Longer-TermOutcomesofLetrozolev.PlaceboAfter5YearsofTamoxifenintheMA.17Trial:AnalysesAdjustingforTreatmentCrossover,PresentedByIanSmithat2014ASCOAnnualMeeting,MA17,HR=0.61，P=.04,Slide17,PresentedByIanSmithat2014ASCOAnnualMeeting,Slide19,PresentedByIanSmithat2014ASCOAnnualMeeting,Slide20,PresentedByIanSmithat2014ASCOAnnualMeeting,Slide21,PresentedByIanSmithat2014ASCOAnnualMeeting,HowLongIsLongEnough?DefiningOptimalDurationandSelectionofAdjuvantEndocrineTherapy,PresentedByIanSmithat2014ASCOAnnualMeeting,ConclusionSoWhatdoWeDoAsClinicians?,PresentedByIanSmithat2014ASCOAnnualMeeting,副作用-ATAC,副作用BIG1-98,副作用-IES,Value-BasedApproachtoSystemicTherapyinPatientswithBreastCancer:WhatistheEvidence?,PresentedByMichaelHassettat2014ASCOAnnualMeeting,Whatdowegetforwhatwespend?,PresentedByMichaelHassettat2014ASCOAnnualMeeting,Value?,PresentedByMichaelHassettat2014ASCOAnnualMeeting,Valuabletreatmentsshouldprodu