Continuous innovation and excellence: change strategy of breast cancer for medication

*For medical professionals for reading reference

According to the latest report of the World Health Organization (WHO), the new cases of breast cancer in the world in 2020 reached 2.26 million, and breast cancer surpassed lung cancer for the first time to become the world's largest cancer. The number of onset cases [1]. Not only that, there are research predictions that the number of new patients with breast cancer in the next 10 years will continue to increase and show a acceleration trend [2].

In the context of this kind of breast cancer medical burden, in the "Healthy China 2030 Outline", the 5 -year survival rate of general cancer by 2030 should not be less than 46.6%[3], how to help early Patients with breast cancer more accurately realize the cure from local control, and how to make advanced breast cancer patients better achieve slow disease management through accurate treatment strategies. It is also a hot medical field that will continue to pay attention to in the future.

As the future, at the time of 2022, on the 21st of the 8th, the seventh Astrian breast cancer was held in Beijing, Shanghai, Guangzhou, Hangzhou, Chengdu, Wuxi and other places at the same time. The conference invited hundreds of well -known experts and professors including Academician Song Erwei and Academician Xu Binghe, and shared viewpoints and experience exchanges around the basic research of breast cancer and various difficult problems in clinical diagnosis and treatment. The selection of expert viewpoints that are more realistic in the selection of breast cancer clinical medication strategies are sorted out to sort out the texts in order to accompany you.

01

Before menopause HR+early breast cancer:

How to optimize endocrine therapy strategies to prevent recurrence?

Cure tumor is an eternal pursuit of scholars in the medical field. In the field of breast cancer, in the era of breast cancer diagnosis and treatment based on molecular classification, hormone receptors (HR) positive/person epidermal growth factor receptor 2 (HER2) negatives Early breast cancer patients' unexpected good prognosis once made people see the hope of cure of breast cancer.

However, with the advent and clinical application of anti -HER2 drugs and new targeted drugs, the prognosis of HER2 positive and three -negative breast cancer has also improved significantly. At this time The risk of recurrence after treatment has become an increasingly prominent issue.

How to prevent recurrence after the treatment of early HR positive breast cancer before menopause? In this regard, Professor Chen Wenjun from Shao Yifu Hospital Affiliated to Zhejiang University Medical College pointed out in his speech entitled "Early Cure: Exploration and Optimization of Earlier Breast Cancer-Endocrine Treatment Strategy" in the pre-menopamental period. Patients with risk enhanced standardized and optimized endocrine therapy.

Professor Chen Wenjun summarizes the optimization scheme of HR positive early breast cancer ovarian function suppression (OFS) strategy before menopause.

For patients with high risk, OFS treatment is promoted: recurrence of breast cancer medium high -risk factors include: positive lymph nodes, <35 years old, menopause, T & 2CM, G2/G3, Ki67 & 30%, etc.; The crowd receives endocrine therapy containing OFS;

Precision treatment of patients with low -risk patients, chemotherapy degradation: 2021 St Gallen consensus proposed for the first time proposed that patients with good postmenopausal tumor biology can exempt chemotherapy. It is recommended that the OFS scheme as a positive early, N0, low gene risk estrogen receptor (ER) positive early stage The best choice for patients with breast cancer.

Professor Chen Wenjun believes that Gosherin+His Moqifen is currently effectively reducing HR positive/HER2 -negative early breast cancer recurrence and risk of death and approval of menstrual stupid breast cancer indications. (GNRHA).

02

HR+advanced breast cancer:

Once relapsed, is the combined medication plan?

As mentioned earlier, the recurrence risk of HR -positive early breast cancer patients is worthy of attention. Long -term auxiliary endocrine therapy is often required to reduce the risk of recurrence after surgery. Among them, the aromatic enzyme inhibitor (AI) endocrine drugs are common choices. However, long -term use of AI will increase the risk of ESR1 mutations, causing ER receptors to continue to activate without estrogen, thereby accelerating tumor growth.

Then, after using AI auxiliary endocrine therapy, once HR -positive breast cancer patients really have recurrence or metastasis, how to choose subsequent medication solutions in order to bring the best survival benefits to patients?

Professor Chen Ying of Guangdong Hospital of Traditional Chinese Medicine conducted an in -depth analysis of the issue of "United Times: HR+Advanced Breast Cancer Medicine". He believes that after the recurrence or metastasis of AI treatment, a combined medication solution based on fluoros group may bring significant survival benefits to patients with advanced HR positive breast cancer.

First of all, theoretically, the dual -action mechanism of Flui Si group can ensure that patients can inhibit ER activation and further degrade ER receptors even if the ESR1 mutation occurs, and fully suppress tumor growth.

Based on this, Professor Chen Ying pointed out that the current domestic and foreign guidelines have unanimously recommended Flui Si group+CDK4/6i for the treatment of HR+advanced breast cancer; and in the future, there will be more joint solutions based on Fluivzi group, Help patients for long -term treatment.

03

HER2+advanced breast cancer:

Treatment is more tricky. What is preferred by medication strategy?

As we all know, compared to HR -positive breast cancer, HER2 positive breast cancer is usually more dangerous, has higher tumor cell malignant degree, faster disease progress, more prone to metastasis, and poor prognosis. Unfortunately, about 15%-25%of patients with breast cancer HER2 expressed or amplified in my country. [4,5]

Professor Lin Ying from the First Affiliated Hospital of Sun Yat -sen University reviewed the history of HER2 -positive breast cancer in the conference speech. He pointed out that before the opening of the precision treatment era, HER2 -positive breast cancer drug treatment was treated , Dorcio and Koriobin and other chemotherapy drugs are mainly, but the treatment effect is not optimistic; it is necessary to enter the era of precise treatment, including targeted therapy including Tushuo Midurate/Puffyzab, TKI, etc. The drug has extended the survival period significantly, but it is still not satisfactory. Most of the current second -line therapy MPFS is less than 1 year, and OS is only 2 to 3 years.

As the organizer of this conference, Astraon has accompanied the majority of patients with breast cancer for more than 40 years. Its breast cancer therapy products have covered HR -positive breast cancer patients from early to late, from early to late stages, and HER2 Patients with positive and three -negative breast cancer, including:

In the history of the 1970s, the first breast cancer endocrine therapy drug that targets estrogen receptors in history He Moqifen;

Patients of patients with breast cancer in the early stage of menopause and the treatment of breast cancer patients in the period of menopause are in the treatment of drugs;

Postmenopausal patients with advanced breast cancer and postmenopausal hormone receptor -positive patients with early breast cancer auxiliary therapy drugs Anatzozole;

Patients with local advanced or metastatic breast cancer treat drugs for the treatment of drugs;

Mr. Chen Kangwei General Manager Chen Kangwei, general manager of Astraikon China Tumor Division, said in his speech that Astraikon will continue to be deployed in the field of breast cancer in the future, actively promote the reform and treatment of innovative drugs, and continue to join hands with political industry, research, research and medicine The first -class partner, jointly create a tumor ecosystem, explore the pathological management and plan of tumors, support Chinese tumor patients to obtain high -quality long -term survival, help the health of China 2030, and light up the light of life for patients.

Looking forward to the help of Astraikon, through the sharing and exchanges of more academic conferences, it promotes my country's breast cancer diagnosis and treatment plan to achieve excellence, thereby enabling the majority of breast cancer patients to benefit more.

references:

[1] Cao W, et al. Changing Profiles of Cancer Burden Worldwide and in China: A Secondary Analysis of the Global Cancer Statistics 2020. Chin Med J (ENGL); 134 (7): 783-791.

[2] Lei S et al. Cancer Biol Med. 2021 May 18: J.ISSN.2095-3941.2020.0523

[3] The Opinions of the State Council on the implementation of a healthy China action. Guofa [2019] No. 13.http: //www.gov.cn/zhengce/content/2019-07/15/content_5409492.htmm

[4] Pala Ee, et al. Proplems in Determing Her2 Status in Breast Carcinoma. J Breast Health. 2015; 11 (1): 10-16.

[5] IQBAL N. IQBAL N. Human Epidermal Growth Factor Receptor 2 (HER2) in Cancers: Overexpression and theRapeutic Implication. Mol Biol Int. 2014; 2014: 852748.

The materials of this article are supported by Astrikon, for reference for medical and health professionals

Approval number: CN-101461, validity to: 2023-8-23

*This article is only used to provide scientific information to medical people, and does not represent the viewpoint of this platform

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