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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/sequentialextendedMA27ANA5YEXE5YFACEANA5YLET5YHe
2、adtoheadATTOMATLASTamoxifen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RSROR淋巴結(jié)轉(zhuǎn)移與生存AnnalsofOncology,2007受體陽(yáng)性乳腺癌患者的生存(SEERData)0.951.000.900.850.800.7501020304050607080Survival(mo)CumulativeproportionsurvivingJointER/PRPhenotypeER+PR+(n=12,811)ER+PR-(n=2,436)ER-PR+(n=663)Node-negativepatient
3、swithT1-T3tumorsHER2陽(yáng)性患者預(yù)后較差TamoxifenAnastrozoleRFSRFSDowsett,JCO,2008Ki-67PatholOncolRes.?20141021-GeneRecurrenceScoreAssayfor Postmenopausal,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)？ATACBIG1-98RelationshipofERlevel andresponsetoE
4、T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
5、nnualMeetingSlide14PresentedByIanSmithat2014ASCOAnnualMeetingLonger-TermOutcomesofLetrozolev.PlaceboAfter5YearsofTamoxifenintheMA.17Trial:
AnalysesAdjustingforTreatmentCrossoverPresentedByIanSmithat2014ASCOAnnualMeetingMA17HR=0.61，P=.04Slide17PresentedByIanSmithat2014ASCOAnnualM
6、eetingSlide19PresentedByIanSmithat2014ASCOAnnualMeetingSlide20PresentedByIanSmithat2014ASCOAnnualMeetingSlide21PresentedByIanSmithat2014ASCOAnnualMeetingHowLongIsLongEnough?
DefiningOptimalDurationandSelectionofAdjuvantEndocrineTherapyPresentedByIanSmithat2014ASCOAnnualMeetingCo
7、nclusion
SoWhatdoWeDoAsClinicians?PresentedByIanSmithat2014ASCOAnnualMeeting副作用-ATAC副作用BIG1-98副作用-IESValue-BasedApproachtoSystemicTherapyinPatientswithBreastCancer:WhatistheEvidence?PresentedByMichaelHassettat2014ASCOAnnualMeetingWhatdowegetforwhatwespend?PresentedByMichaelHasse
8、ttat2014ASCOAnnualM
