乳腺癌内科治疗新进展-胡夕春

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1、乳腺癌内科治疗新进展胡夕春新药新方案新理念新药不良反应及处理1.1白蛋白结合紫杉醇(ABX)ORRPFSABX300mg/m2,Q3W33％ABX100mg/m2,QW×358％ABX150mg/m2,QW×362％多西他赛100mg/m2,Q3W36％1.2EFECT:EvaluationofTreatmentOptionsFollowingAIFailureFulvestrantIMinjectionloading-doseregimen*(n=351)Exemestane25mg/dayorally(n=342)

2、Postmenopausalwomenwithhormonereceptor–positive,progressing/recurringadvancedbreastcancerafternonsteroidalAI(N=693)Progression,death,orwithdrawal*Fulvestrantloading-doseregimencomprised500mgonDay0,250mgonDays14and28,and250mgmonthlythereafter.GradisharW,etal.SABC

3、S2006.Abstract12.EFECT:SimilarTTPinPatientsTreatedWithFulvestrantorExemestaneGradisharW,etal.SABCS2006.Abstract12.00.00.20.40.60.81.034219098412112861ProportionofPatientsProgressionFreeMonthsNo.atRiskFulvestrantExemestane3691215182124273511959650251242000Exemesta

4、neFulvestrantEFECT:PatientResponseandStudyConclusionsMediandurationofresponsetotreatmentwithfulvestrantvsexemestane:13.5vs9.8months,respectivelyFulvestrantaseffectiveandsafeasexemestaneinwomenwithhormonereceptor–positivebreastcancerwhohaveprogressedontreatmentwit

5、hanonsteroidalAIOutcome,%Exemestane(n=342)Fulvestrant(n=351)OddsRatio(95%CI)PValueORR6.77.41.120(0.578-2.186).7364CBR31.532.21.035(0.720-1.487).8534GradisharW,etal.SABCS2006.Abstract12.Anthracyclin-pretreatedandtaxaneresistantN:752RANDOMIZÁCIÓIxabepilone40mg/m

6、2d1静脉滴注3hCapecitabine1000mg/m2po.BIDx14Capecitabine1250mg/m2po.BIDx141.3Ixabepilone+CapecitabinevsCapecitabineL.T.Vahdatetal.ProcASCO2007.Abstr1006Ixabepilone+CapecitabinevsCapecitabineL.T.Vahdatetal.ProcASCO2007.Abstr1006Ixabepilone+CapecitabinevsCapecitabineL.T

7、.Vahdatetal.ProcASCO2007.Abstr1006新药新方案新理念新药不良反应及处理2.1LapatiniboraltyrosinekinaseinhibitorofErbB1andErbB2BlockssignalingthroughEGFRandHER2homodimersandheterodimersMayalsopreventsignalingbetweenErbB1/ErbB2andotherErbBfamilymembersPTENLapatinibP13KpAktRasRafpErkShc

8、Grb2So8PhospholipidcellmembraneTreatmentEfficacy:LapatinibVsLapatinib+Trastuzumab*ConfirmedCR+PR†CR+PR+SD≥6moClinicalResponseLN=145L+TN=146ResponseRate,%*(9