輔助內(nèi)分泌治療方案

一、絕經(jīng)前乳腺癌輔助內(nèi)分泌治療

方案Ⅰ　TAM vs OFS+TAM vs OFS+ AI

TEXT研究（NCT00066703）

方案評價

（安　欣　史艷俠）

參考文獻(xiàn)

［1］ FRANCIS PA，PAGANI O，F(xiàn)LEMING GF，et al.Tailoring adjuvant endocrine therapy for premenopausal breast cancer.N Engl J Med，2018，379（2）:122-137.

二、絕經(jīng)后女性輔助內(nèi)分泌治療

方案Ⅰ　阿那曲唑vs他莫昔芬

方案評價

（安　欣　史艷俠）

參考文獻(xiàn)

［1］ HOWELL A，CUZICK J，BAUM M，et al.Results of the ATAC（arimidex，tamoxifen，alone or in combination）trial after completion of 5 years′adjuvant treatment for breast cancer.Lancet，2005，365（9453）:60-62.

方案Ⅱ　他莫昔芬vs來曲唑

初始來曲唑單藥與他莫昔芬單藥

序貫治療療效

BCFI.無乳腺癌生存期

方案評價

（安　欣　史艷俠）

參考文獻(xiàn)

［1］ KELLY CM，BUZDAR AU.Aromatase inhibitors alone or in sequence with tamoxifen-clinical evaluation of the BIG 1-98 trial.Expert Opin Pharmacother，2010，11（3）:489-492.

［2］ RABAGLIO M，SUN Z，PRICE KN，et al.Bone fractures among postmenopausal patients with endocrineresponsive early breast cancer treated with 5 years of letrozole or tamoxifen in the BIG 1-98 trial.Ann Oncol，2009，20（9）:1489-1498.

［3］ REGAN MM，NEVEN P，GIOBBIE-HURDER A，et al.Assessment of letrozole and tamoxifen alone and in sequence for postmenopausal women with steroid hormone receptor-positive breast cancer:the BIG 1-98 randomised clinical trial at 8.1 years median follow-up.Lancet Oncol，2011，12（12）:1101-1108.

方案Ⅲ　他莫昔芬序貫依西美坦vs他莫昔芬單藥

方案評價

（安　欣　史艷俠）

參考文獻(xiàn)

［1］ COOMBES RC，HALL E，GIBSON LJ，et al.A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer.N Engl J Med，2004，350（11）:1081-1092.

方案Ⅳ　他莫昔芬序貫依西美坦vs依西美坦

方案評價

（安　欣　史艷俠）

參考文獻(xiàn)

［1］ DERKS MGM，BLOK EJ，SEYNAEVE C，et al.Adjuvant tamoxifen and exemestane in women with postmenopausal early breast cancer（TEAM）:10-year follow-up of a multicentre，openlabel，randomised，phase 3 trial.Lancet Oncol，2017，18（9）:1211-1220.

方案Ⅴ　不同AI初始或序貫給藥

（安　欣　史艷俠）

參考文獻(xiàn)

［1］ DE PLACIDO S，GALLO C，DE LAURENTIIS M，et al.Adjuvant anastrozole versus exemestane versus letrozole，upfront or after 2 years of tamoxifen，in endocrine～sensitive breast cancer（FATA-GIM3）:a randomised，phase 3 trial.Lancet Oncol，2018，19（4）:474-485.

三、延長輔助內(nèi)分泌治療時長的探索

方案Ⅰ　他莫昔芬5年vs他莫昔芬10年

方案評價（僅對其中6 846例ER陽性患者進(jìn)行分析）

（安　欣　史艷俠）

參考文獻(xiàn)

［1］ DAVIES C，PAN H，GODWIN J，et al.Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer:ATLAS，a randomised trial.Lancet，2013，381（9869）:805-816.

［2］ GRAY RG，REA D，HANDLEY K，et al.aTTom:Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6，953 women with early breast cancer.J Clin Oncol，2013，31:Suppl:abstract 5.

方案Ⅱ　他莫昔芬5年vs他莫昔芬5年-來曲唑5年

方案評價

（安　欣　史艷俠）

參考文獻(xiàn)

［1］ GOSS PE，INGLE JN，MARTINO S，et al.A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer.N Engl J Med，2003，349（19）:1793-1802.

［2］ GOSS PE，INGLE JN，MARTINO S，et al.Randomized trial of letrozole following tamoxifen as extended adjuvant therapy in receptor-positive breast cancer:updated findings from NCIC CTG MA.17.J Natl Cancer Inst，2005，97（17）:1262-1271.

［3］ WHELAN TJ，GOSS PE，INGLE JN，et al.Assessment of quality of life in MA.17:a randomized，placebocontrolled trial of letrozole after 5 years of tamoxifen in postmenopausal women.J Clin Oncol，2005，23（28）:6931-6940.