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Foreword "2021 Annual Progress Review of Breast Cancer Treatment" was grandly held on January 8, 2022, mainly in the form of an online conference
.
This conference focuses on the important progress in the field of international and domestic breast cancer in 2021, and invites well-known experts and scholars in the field of breast cancer to give keynote speeches on the progress of translational research, surgical treatment, radiotherapy, early breast cancer and advanced breast cancer treatment.
A review summarizing important findings that have changed clinical practice in breast cancer
.
During the meeting, Yimaitong was honored to invite Professor Wang Tao from the Department of Oncology, Fifth Medical Center, PLA General Hospital, to discuss the research progress and treatment pattern in the field of adjuvant breast cancer therapy
.
Expert Profile Professor Wang Tao, MD, Chief Physician, Associate Professor, Master Supervisor Vice-chairman of the Youth Committee of the Prevention and Treatment Society The Standing Committee of the Breast Disease Professional Committee of the Chinese Anti-Cancer Association summarized 2021, looked forward to 2022, and reviewed the progress of adjuvant breast cancer treatment.
The annual breast cancer treatment progress review meeting is coming as scheduled, which is of great significance
.
Summarize 2021, review and discuss the academic progress in the field of international and domestic breast cancer this year, look forward to 2022, and provide evidence-based medicine for better clinical practice in 2022
.
In the adjuvant treatment of hormone receptor (HR)-positive breast cancer, the most important progress this year is the addition of CDK4/6 inhibitors to postoperative endocrine therapy
.
The Monarch E study showed that the addition of a "targeted drug" CDK4/6 inhibitor (abecili) on the basis of the original standard endocrine therapy in high-risk HR-positive breast cancer patients can improve disease-free survival (DFS) and long-term maintain efficacy
.
For triple negative breast cancer (TNBC), which everyone is very concerned about, the more important research this year is the OlympiA study
.
The study included BRCA1/2 germline mutated HER2-negative (HR+ or TNBC) early breast cancer patients, of which TNBC patients accounted for about 85%
.
Studies have shown that adding a year of PARP inhibitor (olaparib) therapy after completion of standard neoadjuvant or adjuvant therapy can further reduce the risk of recurrence and metastasis in patients
.
Professor Wang Tao said that based on the positive results of the OlympiA study, it is also possible to write it into the guideline, but during the one-year intensive treatment process, attention should be paid to adverse reactions as well as curative effects, and safety management should be done to ensure that patients Improve quality of life while surviving
.
The treatment standard of HER2-positive breast cancer has been relatively perfect, and clinical practice is basically carried out in accordance with the original standards of the guidelines, without much change
.
For high-risk patients, dual-target therapy can be considered during postoperative adjuvant therapy; for non-pathological complete remission (non-pCR) patients, TDM1 or continued dual-target therapy can be selected according to specific conditions
.
In the treatment of HER2-positive breast cancer, where will anthracyclines go? In recent years, there have been many discussions on the "de-anthracycline" of HER2-positive breast cancer chemotherapy
.
Professor Wang Tao said that it is inappropriate to "remove anthracyclines" in all HER2-positive breast cancer patients.
At present, there is not enough evidence-based medical evidence to prove that "removal of anthracyclines" is the optimal solution
.
First, in neoadjuvant therapy, the TRAIN-2 study results showed comparable pCR rates and similar event-free survival (EFS) with or without anthracyclines, but long-term follow-up data are still needed
.
In postoperative adjuvant therapy, the guidelines clearly point out that the EC sequential THP or TCbHP regimen is a class of recommended regimens
.
Second, at present, "de-anthracycline" treatment is mainly aimed at patients with comorbidities of heart disease to avoid unnecessary cardiotoxicity caused by anthracyclines
.
In addition, more research is needed in the future to screen the Biomarker to identify the patient group who can benefit from anthracyclines, as well as the patient group that can only be treated with "de-anthracycline"
.
To sum up, it appears that the two treatment regimens with or without anthracyclines are equivalent in efficacy, and it is still too early for all HER2-positive breast cancer patients to "de-anthracycline", and more needs to be done.
studies have confirmed it
.
The booming development of anti-HER2 drugs will affect the pattern of adjuvant therapy.
In recent years, anti-HER2 therapy has progressed rapidly, mainly relying on the advent of new drugs to bring therapeutic benefits to patients
.
At present, anti-HER2 drugs are mainly concentrated in several categories, including antibodies, small molecule tyrosine kinase inhibitors (TKIs) and antibody-drug conjugates (ADCs)
.
These drugs are recommended for early use after good benefits have been observed in the treatment of patients with advanced HER2-positive breast cancer
.
Whether it is recommended by domestic and foreign guideline standards or based on the results of the APHINITY study, the KATHERINE study and other related research results, high-risk patients generally choose a dual-target regimen, and low-risk patients can choose a single-target regimen
.
At the same time, there is also a program similar to the ExteNET study, that is, after completing one year of trastuzumab treatment, patients with high risk factors can be treated with small molecule TKIs for another year sequentially
.
In addition, for non-pCR patients, according to their specific conditions, ADCs can be selected or the dual-target regimen can be continued
.
In general, in the past two years, the pattern of adjuvant therapy for HER2-positive breast cancer has not changed much
.
.
This conference focuses on the important progress in the field of international and domestic breast cancer in 2021, and invites well-known experts and scholars in the field of breast cancer to give keynote speeches on the progress of translational research, surgical treatment, radiotherapy, early breast cancer and advanced breast cancer treatment.
A review summarizing important findings that have changed clinical practice in breast cancer
.
During the meeting, Yimaitong was honored to invite Professor Wang Tao from the Department of Oncology, Fifth Medical Center, PLA General Hospital, to discuss the research progress and treatment pattern in the field of adjuvant breast cancer therapy
.
Expert Profile Professor Wang Tao, MD, Chief Physician, Associate Professor, Master Supervisor Vice-chairman of the Youth Committee of the Prevention and Treatment Society The Standing Committee of the Breast Disease Professional Committee of the Chinese Anti-Cancer Association summarized 2021, looked forward to 2022, and reviewed the progress of adjuvant breast cancer treatment.
The annual breast cancer treatment progress review meeting is coming as scheduled, which is of great significance
.
Summarize 2021, review and discuss the academic progress in the field of international and domestic breast cancer this year, look forward to 2022, and provide evidence-based medicine for better clinical practice in 2022
.
In the adjuvant treatment of hormone receptor (HR)-positive breast cancer, the most important progress this year is the addition of CDK4/6 inhibitors to postoperative endocrine therapy
.
The Monarch E study showed that the addition of a "targeted drug" CDK4/6 inhibitor (abecili) on the basis of the original standard endocrine therapy in high-risk HR-positive breast cancer patients can improve disease-free survival (DFS) and long-term maintain efficacy
.
For triple negative breast cancer (TNBC), which everyone is very concerned about, the more important research this year is the OlympiA study
.
The study included BRCA1/2 germline mutated HER2-negative (HR+ or TNBC) early breast cancer patients, of which TNBC patients accounted for about 85%
.
Studies have shown that adding a year of PARP inhibitor (olaparib) therapy after completion of standard neoadjuvant or adjuvant therapy can further reduce the risk of recurrence and metastasis in patients
.
Professor Wang Tao said that based on the positive results of the OlympiA study, it is also possible to write it into the guideline, but during the one-year intensive treatment process, attention should be paid to adverse reactions as well as curative effects, and safety management should be done to ensure that patients Improve quality of life while surviving
.
The treatment standard of HER2-positive breast cancer has been relatively perfect, and clinical practice is basically carried out in accordance with the original standards of the guidelines, without much change
.
For high-risk patients, dual-target therapy can be considered during postoperative adjuvant therapy; for non-pathological complete remission (non-pCR) patients, TDM1 or continued dual-target therapy can be selected according to specific conditions
.
In the treatment of HER2-positive breast cancer, where will anthracyclines go? In recent years, there have been many discussions on the "de-anthracycline" of HER2-positive breast cancer chemotherapy
.
Professor Wang Tao said that it is inappropriate to "remove anthracyclines" in all HER2-positive breast cancer patients.
At present, there is not enough evidence-based medical evidence to prove that "removal of anthracyclines" is the optimal solution
.
First, in neoadjuvant therapy, the TRAIN-2 study results showed comparable pCR rates and similar event-free survival (EFS) with or without anthracyclines, but long-term follow-up data are still needed
.
In postoperative adjuvant therapy, the guidelines clearly point out that the EC sequential THP or TCbHP regimen is a class of recommended regimens
.
Second, at present, "de-anthracycline" treatment is mainly aimed at patients with comorbidities of heart disease to avoid unnecessary cardiotoxicity caused by anthracyclines
.
In addition, more research is needed in the future to screen the Biomarker to identify the patient group who can benefit from anthracyclines, as well as the patient group that can only be treated with "de-anthracycline"
.
To sum up, it appears that the two treatment regimens with or without anthracyclines are equivalent in efficacy, and it is still too early for all HER2-positive breast cancer patients to "de-anthracycline", and more needs to be done.
studies have confirmed it
.
The booming development of anti-HER2 drugs will affect the pattern of adjuvant therapy.
In recent years, anti-HER2 therapy has progressed rapidly, mainly relying on the advent of new drugs to bring therapeutic benefits to patients
.
At present, anti-HER2 drugs are mainly concentrated in several categories, including antibodies, small molecule tyrosine kinase inhibitors (TKIs) and antibody-drug conjugates (ADCs)
.
These drugs are recommended for early use after good benefits have been observed in the treatment of patients with advanced HER2-positive breast cancer
.
Whether it is recommended by domestic and foreign guideline standards or based on the results of the APHINITY study, the KATHERINE study and other related research results, high-risk patients generally choose a dual-target regimen, and low-risk patients can choose a single-target regimen
.
At the same time, there is also a program similar to the ExteNET study, that is, after completing one year of trastuzumab treatment, patients with high risk factors can be treated with small molecule TKIs for another year sequentially
.
In addition, for non-pCR patients, according to their specific conditions, ADCs can be selected or the dual-target regimen can be continued
.
In general, in the past two years, the pattern of adjuvant therapy for HER2-positive breast cancer has not changed much
.
