雌激素受体阳性乳腺癌内分泌治疗疗效预测标志物研究进展

Progress in predictive markers of neoadjuvant endocrine therapy for ER+ breast cancer

摘要:

乳腺癌是全球范围内女性最常见的恶性肿瘤，极大地威胁广大患者的健康。新辅助治疗不仅能增加保乳手术的比例，还能对治疗的有效性进行体内敏感性测试。尤其是在三阴性和Her2过度表达的亚型中，病理完全缓解是患者长期预后良好的重要预测指标。然而，对于雌激素受体阳性乳腺癌，虽然大多数这种癌症亚型患者的总体预后良好，但因缺乏准确而便捷的疗效预测标志物，临床医生在新辅助内分泌治疗和新辅助化疗之间的决策缺乏可靠的依据。为减少盲目化疗所致的不必要副反应，亟需寻找新的新辅助内分泌治疗预测标志物。本文回顾了现有新辅助内分泌治疗雌激素受体阳性乳腺癌预后标志物的应用和局限性，以及新生物标记物的研究现状。

Abstract:

Breast cancer is the most common malignant tumor of women in the world，which greatly threatens patients' health. Neoad－juvant therapy can not only increase the proportion of breast conserving surgery，but also can test internal sensitivity of treatments' efficacy. Especially in triple negative and Her-2 overexpression subtypes，pathological complete response is an important predictor of long-term prognosis. However，the overall prognosis of most patients with estrogen receptor（ER） positive breast cancer is good，but clinicians lack reliable evidence for decision-making between neoadjuvant endocrine therapy and neoadjuvant chemotherapy due to the lack of accurate and convenient predictors. In order to reduce side effects caused by unnecessary chemotherapy，it is urgent to find new predictive markers for neoadjuvant endocrine therapy. This paper reviewed applications and limitations of prognostic markers in current neoadjuvant endocrine therapy to treat ER+ breast cancer，and the current status of new biomarkers.