演題抄録

臓器別シンポジウム

開催概要
開催回
第58回・2020年・京都
 

ER陽性進行再発乳癌の最新の治療

演題番号 : SY20-2

[筆頭演者]
山下 啓子:1 

1:北海道大学・乳腺外科

 

Endocrine therapy for estrogen receptor (ER)-positive breast cancer was one of the earliest molecular-targeted therapies. The clinical benefit rate for highly endocrine-responsive tumors can be up to 70-80%. Moreover, endocrine therapy causes no severe adverse events and maintains quality of life. However, the development of resistance to endocrine therapy is a common problem for patients with ER-positive advanced breast cancer. We previously reported that endocrine responsiveness after relapse was a key factor for improved post-relapse survival in ER-positive recurrent breast cancer. Different mechanisms might be involved in primary and secondary endocrine resistance. Recently, inhibitors of molecules within well-defined signaling pathways, such as mammalian target of rapamycin (mTOR), cyclin-dependent kinase 4 and 6 (CDK4/6), phosphatidylinositol 3 kinase (PI3K), and akt murine thymoma viral oncogene (AKT), have been developed and are used in combination with endocrine therapies for overcoming endocrine resistance. Notably, improvement in overall survival has been reported with CDK4/6 inhibitors when combined with endocrine therapy. In addition, the resistance mechanisms associated with CDK4/6 inhibitors including cell cycle alterations and activation of upstream tyrosine kinase receptors have been identified. Preclinical and translational work suggests that the landscape of resistance to targeted agents is heterogeneous. Thus, tailored therapeutic management of patients with ER-positive breast cancer is currently pursued. The discovery of accurate predictive biomarkers for targeted agents is required.

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