Professor Ma Fei: New progress in breast cancer treatment in 2020

Professor Ma Fei is a physician, professor and doctoral tutor of the National Cancer Center/Director of the Internal Medicine Treatment Center of the Oncology Hospital of the Chinese Academy of Medical Sciences and Vice Chairman of the Breast Cancer Special Committee of the National Cancer Quality Control Center, Deputy Chairman of the Oncology Specialist Pharmacist Branch of the Chinese Pharmaceutical Association, Deputy Chairman of the Integrated Oncology and Cardiology Branch of the China Anti-Cancer Association, Deputy Chairman of the Multigene and Unknown Oncology Committee of the Chinese Anti-Cancer Association, and Secretary-General of the National Cancer Association of China Deputy Chairman of the Women's Ovarian Protection and Anti-Aging Promotion Engineering Committee, Director-General of the Geriatric Oncology Branch of the Chinese Society of Gerontology and Geriatrics, Chairman of the Breast Cancer Youth Committee of the Chinese Medical Association, Chairman of the Special Committee on The Quality Control and Improvement of Cancer Treatment in Beijing, Chairman of the Health Management Committee of the Beijing Breast Disease Prevention and Control Society, Vice Chairman of the Breast Cancer Youth Committee of the Chinese Anti-Cancer Association, and other editorial boards of the Chinese and English magazines.
to undertake the National Natural Science Foundation, 863 and many other major national scientific research projects, in JCO and other well-known journals at home and abroad published more than 60 academic articles, compilation of oncology monographs 13, won the second prize of national scientific and technological progress, the first prize of science and technology of the China Anti-Cancer Association and other provincial and ministerial-level scientific research awards 9, won the national patent authorization 4, won the "Top Ten Outstanding Young Doctors in the Capital", "China Young Cancer Scientist Award" and other honorary titles.
The level of diagnosis and treatment of breast cancer in the oncology department of Beijing Concord Medical College of the Chinese Academy of Medical Sciences has been increasing year by year, with a five-year survival rate of up to 90% and far exceeding that of other cancers.
treatment of breast cancer has initially formed a mature system including chemotherapy, targeted therapy, endocrine therapy and immunotherapy.
recent years, "precision treatment" has gradually received attention, in order to further improve the prognostic and improve the quality of life of breast cancer patients, it is necessary to develop more individual treatment strategies.
this paper will summarize the major advances in breast cancer chemotherapy, targeted therapy, endocrine therapy and immunotherapy over the past year, and look forward to the future direction of breast cancer treatment in order to better guide the individual precision treatment of breast cancer.
1, chemotherapy chemotherapy as an important part of breast cancer treatment, is one of the main means to improve patient survival and prognostication, but chemotherapy is prone to drug resistance, adverse reactions are heavy, which is an urgent problem to be solved.
Postoperative intensive therapy for patients with triple negative breast cancer (triple negative breast cancer, TNBC) who still have tumor remains after new assisted chemotherapy has been accepted at home and abroad, while the use of capedabin intensive treatment during the simple postoperative assisted treatment phase has not been conclusive.
SYSUCC-001 study explored the benefits of 1 year of postoperative standard assisted therapy after TNBC's postoperative standard assisted therapy, and showed that after 5 years of medium follow-up, patients receiving Capentabin treatment after surgery did not have 5 years The rate of disease survival (disease free survival, DFS) was significantly higher than that of the observation group (82.8%:73.0%), and the relative risk of recurrence was reduced by 36.0% in patients, especially the risk of pulmonary metastasis by 50%.
results provide significant clinical benefits for early TNBC patients with beat chemotherapy-enhanced complementary therapy after standard treatment, providing valuable evidence for improving TNBC's poor prognostics.
is a new type of micro-tube inhibitor.
Study-301 study looked at patients with advanced breast cancer after treatment with cyanocyclycertic and yew drugs, and in the TNBC subgroup, compared with the Capathamin group, the total survival time of all-in-one patients in the Allied group was extended by five months, reducing the risk of death by 29.8 percent, providing a new treatment option for metastasis TNBC, which lacked effective treatment.
the results of the RU011201I study were presented at the 2020 Meeting of the American Society of Clinical Oncology (ASCO), and the first- or second-line treatment of human epidermal growth factor receptor 2 (human epidermal growth factor receptor) 2,HER2) The clinical efficacy of negative advanced breast cancer is comparable, the hematological toxicity of Alyblin is heavier than that of yew alcohol, and the nature and severity of peripathy are similar in both groups of patients, but The data on the incidence time, duration and interference with daily life are more advantageous and more safe.
subgroup analysis of 304 studies conducted in China showed that compared with the Changchun Ruibin group, the neurotoxicity of patients in the Aliblin group appeared later and the proportion of autologic neuropathy was lower.
more joint Alyblin-based programme studies are under way to provide more effective options for patients with metastasis breast cancer.
See in detail: Alyblin is an important treatment option for post-treatment chemotherapy for advanced breast cancer cyanocytes GeparOcto Phase III.Phase clinical studies into group TNBC or HER2-positive or high-risk hormone receptors (hormone receptor, HR) positive, HER2-negative patients, respectively, received dose-intensive table-based phosphate, yew alcohol and cyclophosphamide (iddEPC) program or weekly therapy of phosphate. The results of the 47-month follow-up to the study were published at the 2020 European Society of Oncology (ESMO) meeting, and the new auxiliary chemotherapy IddEPC and PM (Cb) groups survived the insalent disease in both the overall queue and the HER2-positive and TNBC subgroups There was no significant difference between IDFS) and OS, but HR-positive, HER2-negative patients benefited from better IDFS and OS applications with idDDEPC, which also supported the benefit of new complementary chemotherapy for her2-negative breast cancer in Luminal type.
utidelone (UTD1) is a genetically engineered Ebomycin analogue and a new class of non-yew anti-micro-tube protein polymerization anti-tumor drugs.
BG01-1323L study aims to assess the effectiveness and safety of Ukip's combined carpentry for patients with advanced breast cancer who failed treatment with cyclocyclin/yew drugs. Free survival, PFS) time (8.4 months: 4.1 months), medium OS time (19.8 months: 16.0 months) and objective remission rate (objective response rate, ORR) (45.6%: 23.7%) were all better than the Caperthabin group, providing more effective treatment options for patients with advanced breast cancer.
2, targeted treatment With the continuous deepening of research on the pathogenesis of breast cancer and the continuous development of precision medicine, the molecular targeted treatment of breast cancer has made new progress.
targeted therapy can kill tumor cells efficiently and selectively, and adverse reactions are lower than chemotherapy.
2.1 HER2-positive breast cancer targeted treatment 2.1.1 New complementary treatment For early breast cancer, how to improve the quality of life with low-toxic treatment programs under the premise of seeking cure is a worth exploring direction.
results of the
BCIRG-006 study confirmed that the complementary treatment of dossytaser- carptonin-curto-bead monoanti (TCH) and dorobi star-cyclophosphamide sequential dorcytas and curto-pearl single The 10-year DFS and OS of the ac-TH program are similar, but at the new assisted treatment stage, which option will enable the patient to obtain greater pathological complete remission (pathologic complete response, pCR) rate is not yet conclusive.
neoCARH study, published at the 2020 ASCO Conference, compared for the first time the new auxiliary chemotherapy TCH program with the table-soft star-cyclophosphamide sequential docetaxel-curto-bead monoanti (EC-TH) program, and the results showed that the TCH group The pCR rate was significantly higher in patients than in the EC-TH group (56.1%:38.5%), and the incidence of adverse reactions was similar in terms of safety, indicating that the TCH scheme might be more suitable for new complementary treatments for HER2-positive breast cancer.
train-2 study is the first phase III. clinical study to evaluate the new complementary treatment of herring-free cyclic drug chemotherapy combined with cocoon bead monoantigen and patojutamodys for HER2-positive early breast cancer patients.
Previous studies have suggested that dual-target therapy has no effect on patient pCR rates, and the 2020 ASCO conference updated its three-year follow-up data, which showed that the two-target-based combined cyclic drugs did not benefit patients, whether it was early-stage study endpoint pCR, or long-term research endpoint event-free survival and OS, no-cyclic drug programs showed good efficacy and better safety. the
WSG-TP-II study was the first to evaluate the prospective study of combined endocrine therapy in patients with HR-positive, HER2-positive early breast cancer, showing that the pCR rate of patients in the combined chemotherapy group increased significantly (56.8%:23.9%), reflecting the advantages of two-target combination chemotherapy.
2.1.2 Postoperative Assisted Therapy Chemotherapy combined with HER2 targeted treatment continued HER2 targeted treatment is the standard treatment of HER2-positive early breast cancer, and T-DM1 is the standard auxiliary treatment for patients with residual immersion lesions after the new auxiliary treatment, however, for high-risk groups, tumor toxicity recurrence and systemic chemotherapy-related problems have not been resolved.
KAITLIN study aims to explore whether the replacement of yew drugs and curt bead monoantigens with T-DM1 can improve the efficacy of complementary treatment and reduce toxicity. At present, the study has not reached the main endpoint IDFS, initially found that patients with positive lymph nodes received chemotherapy aided by cyclocyclyctic drugs, the use of T-DM1 instead of fir alcohol and quercetin bead monoantigen failed to significantly improve the efficacy, in terms of safety, T-DM1 group than curtoju single resistance group has more adverse events caused by the suspension of drugs.
2.1.3 Advanced rescue therapy For HER2-positive advanced breast cancer patients, the most basic treatment principle is systematic treatment of combined anti-HER2 therapy, for patients who failed anti-HER2 treatment, continuous suppression of the HER2 path can bring survival benefits to patients.
PHEBE study presented at the 2020 ASCO Conference showed that pyridoxine combined carpentin significantly extended patients' PFS time compared to Rapatinib's combined carpentry. (12.5 months: 6.8 months), the ORR and clinical benefit rates of patients in the pyridoxine group were significantly higher than those in the Rapatinib group, and although the current OS results are not yet mature, the trend of benefits in the pyridoxine group is significant, with a one-year OS rate of 91.3%.
taking into account factors such as the safety, effectiveness, accessability and patient's financial situation, pyridoxine combined carpetamine has been approved in China as an option for second-line treatment for HER2-positive metastasis breast cancer patients.
PRECIOUS study is a Phase III.III. clinical study of patojudan as a third- or fourth-line retrerapy for HER2-positive breast cancer patients who have previously received Pato-Pearl monoantigen (P), curto-pearl monoantigen (T) and chemotherapy (C), 2020 The results of the study, published at the San Antonio Breast Cancer Symposium (SABCS), showed that the PTC group's mid-level PFS time was significantly better than that of the TC group (5.3 months: 4.2 months), making it possible to treat the single anti-cross-line.
of her2-positive breast cancer are prone to brain metastasis, but there are fewer treatment options for such patients.
tucatinib is a highly selective oral tyrosine kinase inhibitor with high target selectivity for HER2.
2020 ASCO meeting updated the data from the HER2CLIMB study to add tucatinib to the herring positive transfer of brain metastasis after curt bead monoanti, Patoju monoantigen, and T-DM1 treatment. In patients with breast cancer, the intracranial remission rate was increased to 47.3%, the central nervous system PFS time was extended by 5.7 months (9.9 months: 4.2 months), and the risk of intracranial progression or death was reduced by 2/3.
The study suggests that tucatinib combined quercturt bead monoantigen and carpedabin may become new treatment options for HER2-positive metastasis breast cancer patients who have been treated with or without brain metastasis.
trastuzumab deruxtecan (DS-8201) is a new antibody drug conjugate (antibody drug conjugate, ADC) consisting of humanized monoclonal antibodies targeted at HER2, cutable tetrapeptide connections, and effective topological isomerase I. inhibitors.
DESTINY-Breast01 study, reported at the 2019 SABCS conference, showed that HER2-positive metastasis breast cancer patients treated with multiple lines and T-DM1 received DS-8201 treatment with ANR up to 60.9% and median PFS time of 16.4 months