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1、絕經(jīng)后激素受體陽(yáng)性乳腺癌患者高危人群的內(nèi)分泌治療北京大學(xué)人民醫(yī)院王殊ER陽(yáng)性患者預(yù)后EBCTCG,Lancet.2005Long-TermRiskofBreastCancerPresentedByIanSmithat2014ASCOAnnualMeetingClinicaltrialsMA17AnastrozoleletrozoleexemetaneBIG1-98ATACABCSG6aIESB33ABCSG-8ARNO95/ITATEAMUpfrontswitch/sequentialextendedMA27ANA5YEXE5YFACEANA5YLET5YHeadtoheadATTOMATLA
2、STamoxifen高危人群腫瘤大小淋巴結(jié)轉(zhuǎn)移組織學(xué)分級(jí)ER/PRHER2Ki67分子分型RSRORHER2陽(yáng)性患者預(yù)后較差TamoxifenAnastrozoleRFSRFSDowsett,JCO,2008Ki-67PatholOncolRes.?20141021-GeneRecurrenceScoreAssayforPostmenopausal,ER(+)BreastCancerLancetOncol.2010高危人群風(fēng)險(xiǎn)控制AI還是TAM?初始還是序貫?5年還是更長(zhǎng)?高危人群風(fēng)險(xiǎn)控制AI還是TAM?初始還是序貫?5年還是更長(zhǎng)?ATACBIG1-98RelationshipofERlev
3、elandresponsetoET高危人群風(fēng)險(xiǎn)控制AI還是TAM?初始還是序貫?5年還是更長(zhǎng)?BIG1-98序貫高危人群風(fēng)險(xiǎn)控制AI還是TAM?初始還是序貫?5年還是更長(zhǎng)?PooledanalysisATLAS+aTTom:
BreastCancerMortalityPresentedByIanSmithat2014ASCOAnnualMeetingExtendedAdjuvantTherapywithAIs
PresentedByIanSmithat2014ASCOAnnualMeetingSlide13PresentedByIanSmithat2014ASCOA
4、nnualMeetingSlide14PresentedByIanSmithat2014ASCOAnnualMeetingLonger-TermOutcomesofLetrozolev.PlaceboAfter5YearsofTamoxifenintheMA.17Trial:
AnalysesAdjustingforTreatmentCrossoverPresentedByIanSmithat2014ASCOAnnualMeetingMA17HR=0.61,P=.04Slide17PresentedByIanSmithat2014ASCOAnnualMeetingSlide19Pres
5、entedByIanSmithat2014ASCOAnnualMeetingSlide20PresentedByIanSmithat2014ASCOAnnualMeetingSlide21PresentedByIanSmithat2014ASCOAnnualMeetingHowLongIsLongEnough?
DefiningOptimalDurationandSelectionofAdjuvantEndocrineTherapyPresentedByIanSmithat2014ASCOAnnualMeetingConclusion
SoWhatdoWeDoAsClinici
6、ans?PresentedByIanSmithat2014ASCOAnnualMeeting副作用-ATAC副作用BIG1-98副作用-IESValue-BasedApproachtoSystemicTherapyinPatientswithBreastCancer:WhatistheEvidence?PresentedByMichaelHassettat2014ASCOAnnualMeetingWhatdowegetforwhatwespend?PresentedByMichaelHassettat2014ASCOAnnualMeetingValue?PresentedByMichaelHa
7、ssettat2014ASCOAnnualMeetingValuabletreatmentsshouldproduceoutcomesthatreflectmeaningfulclinicalbenefittopatientsPresentedByMichaelHassettat2014ASCOAnnualMeetingThanks!