JCO:使用生物标记物指导早期浸润性乳腺癌妇女辅助性全身治疗

2017-07-18 xuyihan MedSci原创

ASCO(American Society of Clinical Oncology)使用生物信号的方法促进指南更新。此次聚焦更新的III期随机MINDACT(芯片显示淋巴结阴性和1-3个阳性的淋巴结可以避免化疗)研究评估了6693例乳腺癌妇女的MammaPrint分析,也提供了一个新信号。一个专家小组审查了MINDACT研究结果以及其他已发表的关于MammaPrint分析的文献,从而评估其临床应

ASCOAmerican Society of Clinical Oncology)使用生物信号的方法促进指南更新。此次聚焦更新的III期随机MINDACT(芯片显示淋巴结阴性和1-3个阳性的淋巴结可以避免化疗)研究评估了6693例乳腺癌妇女的MammaPrint分析,也提供了一个新信号。一个专家小组审查了MINDACT研究结果以及其他已发表的关于MammaPrint分析的文献,从而评估其临床应用的证据。

如果一个病人有激素受体-阳性、人类表皮生长因子受体2(HER-2)-阴性、淋巴结阴性的乳腺癌,MammaPrint分析因其可识别预后好、潜在效益有限的化疗人群,可用于告知高风险患者不使用辅助性全身化疗。临床风险低的妇女并不受益于化疗,无论是否在基因MammaPrint风险组。因此,MammaPrint分析在这类患者中没有临床使用价值。

如果病人有激素受体-阳性、HER2阴性、淋巴结阳性的乳腺癌,MammaPrint分析可用于告知有1-3个阳性淋巴结和高临床风险的患者不使用辅助性全身化疗。然而,应该告知这些患者不能排除化疗获益,特别是在一个以上淋巴结阳性的患者。

临床医生不应该使用MammaPrint分析指导决策激素受体-阳性、HER2-阴性、淋巴结阴性的低风险患者进行辅助性全身治疗,以及HER2-阳性或者三阴性乳腺癌患者,因为这这些人群中缺乏明确的数据。

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    2018-02-04 lidong40
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    2018-01-23 wjywjy
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