Exploring the concepts and practices of advanced breast cancer treatment: a narrative review

doi:10.21037/atm-21-1458

	Exploring the concepts and practices of advanced breast cancer treatment: a narrative review
	Wang, Xiaojia 1,2; Shao, Xiying 1,2; Huang, Jian 1,2; Lei, Lei 1,2; Huang, Yuan 1,2; Zheng, Yabing 1,2; Cao, Wenming 1,2; Chen, Zhanhong 1,2
刊名	ANNALS OF TRANSLATIONAL MEDICINE
	2021-04-01
卷号	9
关键词	Metastatic breast cancer (MBC) treatment cure molecular types targeted therapy
ISSN号	2305-5839
DOI	10.21037/atm-21-1458
通讯作者	Chen, Zhanhong(czred@sina.com)
英文摘要	Objective: To explore the concepts and practices of advanced breast cancer treatment. Background: Metastatic breast cancer (MBC) has become a chronic disease, with a median overall survival (OS) of around 3 years and a 5-year survival rate of about 25%. OS are strongly associated with the best available care, which consists of not only application of guidelines, but also multidisciplinary specialized care, the most efficacious medicines, and so on. Advanced breast cancer (ABC) Guidelines are the most important and authoritative guidelines for MBC. Methods: In this review, we demonstrate the history and evolution of the global ABC Guidelines. Since 2015, Chinese multidisciplinary experts have drafted guidelines for clinical diagnosis and treatment of MBC. All of these ABC guidelines describe specialized therapeutic principles for different subtypes MBC in detail. Encouragingly, we have found that some special subtypes are hopeful of being cured, such as HER2 positive patients with low tumor burden or HR-positive (HR+) MBC with non-visceral metastasis. In our opinion, the definition of cure of MBC is that MBC patients achieve CR and remain for more than five years after systemic treatment, including those with local therapy. Consequently, we also have conducted some researches and meaningful explorations in different subtypes of MBC. In HER2 positive MBC, our study revealed that regular HER2 circulating extracellular domain (ECD) assay can provide the real-time monitoring of tumor burden and prediction of poor outcome, and may present an important opportunity to reassess HER2 status. In HR+ MBC, we suggested that hormone therapy (HT) maintenance is the priority choice for HR+/HER2- MBC after first-line combined chemotherapy. Besides, our real-world study revealed that fulvestrant combined with ovarian suppression was an active option for premenopausal HR+/HER2- MBC. And also, we observed that everolimus (low-dose) combined with hormone therapy was still effective for HR+/HER2- MBC. For mTNBC patients, we found that THA and endostatin exhibited potential efficacy and was well tolerated in pretreated patients. Conclusions: Our concepts and practices will contribute to the design of relevant clinical research and accumulation of evidence, and cure of MBC is promising.
资助项目	Key Project of Science and Technology Program of Zhejiang Province[2012C13019-1] ; Natural Science Foundation[81672597] ; Zhejiang Provincial Natural Science Foundation[Y2101312] ; Zhejiang Provincial Natural Science Foundation[LY17H160041] ; Zhejiang Provincial Medical Science and Technology Program[2021KY551]
WOS关键词	INTERNATIONAL CONSENSUS GUIDELINES ; CHEMOTHERAPY ; CAPECITABINE ; FULVESTRANT ; COMBINATION ; MULTICENTER ; THERAPY ; WOMEN
WOS研究方向	Oncology ; Research & Experimental Medicine
语种	英语
出版者	AME PUBL CO
WOS记录号	WOS:000647719800007
资助机构	Key Project of Science and Technology Program of Zhejiang Province ; Natural Science Foundation ; Zhejiang Provincial Natural Science Foundation ; Zhejiang Provincial Medical Science and Technology Program
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/122420]
专题	中国科学院合肥物质科学研究院
通讯作者	Chen, Zhanhong
作者单位	1.Chinese Acad Sci, Inst Canc & Basic Med ICBM, Hangzhou, Peoples R China 2.Univ Chinese Acad Sci, Zhejiang Canc Hosp, Canc Hosp, Dept Med Oncol Breast Canc, Hangzhou, Peoples R China
推荐引用方式 GB/T 7714	Wang, Xiaojia,Shao, Xiying,Huang, Jian,et al. Exploring the concepts and practices of advanced breast cancer treatment: a narrative review[J]. ANNALS OF TRANSLATIONAL MEDICINE,2021,9.
APA	Wang, Xiaojia.,Shao, Xiying.,Huang, Jian.,Lei, Lei.,Huang, Yuan.,...&Chen, Zhanhong.(2021).Exploring the concepts and practices of advanced breast cancer treatment: a narrative review.ANNALS OF TRANSLATIONAL MEDICINE,9.
MLA	Wang, Xiaojia,et al."Exploring the concepts and practices of advanced breast cancer treatment: a narrative review".ANNALS OF TRANSLATIONAL MEDICINE 9(2021).