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The newly released 2020 edition of the Chinese Society of Clinical Oncology (CSCO) Breast Cancer Diagnostic Guidelines, based on the significant progress made in ACE research on epigenetic regulatory therapy for endocrine-resistant breast cancer, lists the Sidabenamine joint program as a recommendation for Class I treatment for patients with TAM treatment failure sand and non-steroidal AI treatment failure (evidence level 1A)The application of HDAC inhibitor Sidabenamine in the field of breast cancer treatment has also attracted much attentiondrug resistance remains a challenge for HR-HER2-breast cancer treatment
breast cancer has different molecular types, of which HR-HER2-breast cancer has a higher proportionEndocrine therapy plays an important role in the systematic treatment of HR-HER2-breast cancer, bringing about important changes in the outcome of treatment for patients with this type of breast cancerHowever, endocrine therapy of HR-HER2-advanced breast cancer still has some difficulties and challengesHR-HER2-breast cancer, also known as hormone-dependent breast cancer, is sensitive to endocrine therapy, but 30% of breast cancer patients have primary resistance to endocrine therapy, or after initial effectiveness of secondary resistance, so drug resistance problems have been plagued by HR-HER2-breast cancer treatmentHow to overcome drug resistance and improve drug efficacy is a very important research direction for HR/HER2-breast cancersidabenamine or will rewrite hr - HER2-advanced breast cancer clinical treatment practicewell known, steroid aromatase inhibitors for HR / HER2-breast cancer and non-steroidal resistance patients are very inefficient, no progression survival (PFS) is also very short, so on the basis of steroid aromatase inhibitors to further improve the efficacy of the direction of exploration in recent years, such as steroid drugs combined with mTOR inhibitorsThe ACE study was based on the addition of sidabenamine-histone deacetylase (HDAC) inhibitors to patients who sit failed endocrine therapy for HR-HER2-breast cancerThrough the preliminary basic research, it is learned that there are obvious epigenetic abnormalities in the development of tumor breast cancerSidabenamine is through the epigenetic regulation mechanism to play a corresponding role in tumor treatmentIt directly induces tumor cell cycle blocking and apoptosis, and reverses epithelial cell-inter-charge conversion, thereby inhibiting tumor metastasisAt the same time, it can play the role of immune regulation and improve the immune microenvironment Sidabenamine not only has a general anti-tumor mechanism, but also has a specific anti-tumor mechanism for breast cancer For HR-positive breast cancer, Sidabenamine can inhibit the reactive activation of bypass growth factor receptor signaling pathways and reverse endocrine resistance And by increasing the level of acetylation at certain sites of ER, the ligand dependence activation pathway is directly inhibited The ACE study was initiated by Chinese scholars, and the study produced very encouraging results, with the median PFS and ORR combined to double the efficacy of the control group, which will successfully change the clinical practice of HR-HER2-advanced breast cancer Sidabenamine Future Research Outlook
just talked about the ACE study confirmed that the application of the steroid drug combined with sidabenamine after the failure of hr-HER2-advanced breast cancer treatment can lead to a significant increase in PFS, but we are also well aware that there are many other options clinically for patients who fail to treat endocrine therapy Thus, for the future clinical application of sidabenamine in breast cancer, may consider the combination of sidabenamine and estrogen receptor antagonists, or with other drugs, even in the field of early-stage treatment, Sidabenamine can also be boldly tried With more and more CDK4/6 inhibitors being used in the field of first-line therapy, the combination of histone deacetylase inhibitor sidabenamine is well worth exploring for this part of patients who have used CDK4/6 inhibitors The success of the ACE study has opened the door to histone deacetylase inhibitors in the treatment of HR-HER2-advanced breast cancer, and to further explore the actual clinical value of Sidabenamine in this category of breast cancer patients in the future In short, the future application of Sidabenamine in breast cancer is very promising Author: Name Source: on The of Oncology