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HER2 breast cancer patients are divided into hormone receptor-positive Luminal type and hormone receptor-negative triple-negative type according to hormone receptor typ.
Next, Hao Chunfang, Director of Breast Internal Medicine, Tianjin Medical University Cancer Hospital, explained in detail the "adjuvant treatment of non-HER2-positive breast cancer patients" with the help of the 2021 version of the CBCS guideline.
Before treatment, the risk of recurrence and metastasis of breast cancer should be assessed first, which is the basis of all treatment plan.
There are also many detection tools for multiple genes in breast cance.
Adjuvant chemotherapy was guided by the TAILORxI clinical trial based on Oncotype DX (21 genes.
Adjuvant chemotherapy was also guided by the MINDACT clinical trial based on the MammaPrint genetic tes.
In the recommendation of hormone receptor-positive HER2-negative postoperative adjuvant chemotherapy, genetic testing tools are used to stratify intermediate-risk patient.
Specific recommendations for adjuvant chemotherapy strategies for hormone receptor-positive HER2-negative breast cancer are as follow.
Recommendations for adjuvant chemotherapy strategies for triple-negative breast cancer are as follow.
Why is triple negative breast cancer the preferred population for neoadjuvant therapy? That is because through the information screening of neoadjuvant therapy, after the conventional anthracycline and taxane regimens have been used, the evaluation is based on postoperative evaluatio.
In addition, PARP inhibitors are also emerging in the treatment of non-HER2 breast cance.
OlympiA is a multicenter randomized placebo-controlled phase III trial of olaparib in the adjuvant treatment of gBRCA1/2-mutated high-risk HER2-negative early breast cancer after (neo)adjuvant chemotherap.
Another important study is the monarchE study on Abemaciclib combined with adjuvant endocrine therapy for HR+/HER2-, node-positive, high-risk early breast cance.
For adjuvant endocrine therapy, the initial treatment regimen should be selected after stratifying according to menopausal statu.
In general, for adjuvant chemotherapy, it should be stratified according to risk, step-by-step, and precise exploratio.