Growth factor signalling in clinical breast cancer and its impact on response to conventional therapies: the Edinburgh experience
Growth factor signalling in clinical breast cancer and its impact on response to conventional therapies: the Edinburgh experience
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DOI：
10.1677/erc.1.00995
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发表时间：
2005-07-01
影响因子：
3.9
通讯作者：
Dixon, JM
中科院分区：
文献类型：
--
作者：
Miller, WR;Anderson, TJ;Dixon, JM
在原发肿瘤仍在乳房时给予新辅助内分泌治疗，提供了一个非常有用的模型系统，通过该模型系统确定与新生耐药和早期获得性耐药迹象相关的机制。最重要的是，该模型具有临床相关性。已经证实，肿瘤雌激素受体的缺失导致了对内分泌治疗的抵抗。用第三代芳香酶抑制剂来曲唑进行新辅助治疗后肿瘤细胞增殖的早期变化不能准确预测随后的临床反应。此外，后期看到的增殖变化可能是反应的结果，可能与早期耐药性有关。c-erbB2的高表达不会降低肿瘤对芳香酶抑制剂新辅助治疗的反应，但与治疗前和治疗期间的高肿瘤增殖有关。这些特征是否会导致后续的治疗抵抗和辅助治疗的早期复发还有待确定。
Neoadjuvant endocrine treatment in which therapy is given while the primary tumour is still in the breast provides a highly useful model system by which to identify mechanisms associated with de novo resistance and signs of early acquired resistance. Most importantly, the model is clinically relevant. It has been confirmed that the absence of tumour oestrogen receptors confers resistance to endocrine therapy. Early changes in tumour cell proliferation following neoadjuvant treatment with the third-generation aromatase inhibitor, letrozole, do not predict accurately for subsequent clinical response. Additionally, changes in proliferation seen at later times can be the consequence of response and may be associated with early resistance. High expression of c-erbB2 does not reduce tumour responses to neoadjuvant treatment with aromatase inhibitors, but is associated with high tumour proliferation before and during treatment. It remains to be determined whether these characteristics confer subsequent resistance to treatment and early relapse in the adjuvant setting.