[ASCO2014]乳腺癌内分泌治疗指南更新——Harold J. Burstein教授访谈

作者:  H.J.Burstein   日期:2014/7/5 18:39:13  浏览量:46025

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正如大家所知道的,我们最近更新了ASCO内分泌治疗指南。我们推荐更多的患者考虑将他莫西芬治疗时间延长至10年,或者前5年以他莫西芬治疗,后五年以芳香化酶抑制剂治疗。这是基于2项全球临床试验的结果,即ATLAS和aTTom研究

  Oncology Frontier: The ALTTO study and the combination analysis of TEXT and SOFT are the two hot topics at ASCO 2014. The final result will be presented on 1st June. Can you predict the results and their significance on clinical practice?

  《肿瘤瞭望》:在ASCO2014上,ALTTO研究、TEXT和SOFT研究的合并分析是两大热点。请您谈一下这些结果以及其在临床实践中的重要性?

  Dr Burstein: The ALTTO study is a trial of adjuvant lapatinib to trastuzumab for HER-2 positive breast cancer. We know that in the preoperative setting, adjuvant lapatinib increases the chance of the tumor disappearing with therapy, but what we now want to see if this translates into a long-term reduction in cancer recurrence. I think it is going to be very interesting to see what those data show especially because the FDA has recently moved to a model where they are willing to grant approval if there is a dramatic impact on neoadjuvant treatment results weighting those results in the adjuvant setting. So it should be a very interesting study to see the results for. The TEXT trial is a study of two different strategies of ovarian suppression with tamoxifen or ovarian suppression with an aromatase inhibitor. My guess is that from other studies on post-menopausal breast cancer where there are small differences favoring the aromatase inhibitors, it begs the important question of what’s the role of ovarian suppression for young women? Those data are not anticipated to be presented here but may be available later this year.

  Burstein教授:ATLLO研究对比了拉帕替尼与曲妥珠单抗在Her-2阳性乳腺癌辅助治疗中的效果。我们知道,拉帕替尼用于术前新辅助治疗,能够增加肿瘤消除率,但对于这种治疗方法是否能够降低远期复发率,我们尚不清楚。美国FDA最近有一项举措,即如果一个药物对新辅助治疗效果造成显著的影响,将增加这个药物被批准用于辅助治疗的可能性。因此,我们非常期待这一研究结果应用于临床。TEXT试验比较了他莫西芬和芳香化酶抑制剂对卵巢功能的抑制作用。其他同类型研究结果显示,芳香化酶抑制剂在抑制绝经后女性乳腺癌患者卵巢功能方面具有微弱优势,因此我猜TEXT试验最终结果取决于一个关键问题:卵巢功能抑制在年轻乳腺癌患者中扮演着什么样的角色?这些数据预计将在今年内揭晓。

  Oncology Frontier: What’ s the most attractive aspect for you at this year’s ASCO meeting?

  《肿瘤瞭望》:本次大会您最感兴趣于哪项研究?

  Dr Burstein: What is very exciting about being at ASCO isn’t necessarily the headline trials (we obviously want to know those results but they are everywhere). What’s exciting is to see the things that are just starting to blossom – the early signals of something in a poster or a small randomized trial that gives a very tantalizing clue. That’s the joy of being at a meeting like this; to see hopefully what the future is going to bring.

  Burstein教授:身处ASCO会议现场,最令人感到兴奋的并不一定是那些占据头条的临床试验(当然,我们想知道这些研究的结果,但结果我们可以通过各种渠道获悉),而是能够看到一些暂露头角的东西,比如一个海报所发布的早期信号、或一个小型随机研究给出引人入胜的提示等等。这些才是参加这种会议的兴奋之处,它让我们看到未来可能的发展方向。

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