Research needs in breast cancer
Research needs in breast cancer
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DOI：
10.1093/annonc/mdw571
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发表时间：
2017-02-01
影响因子：
50.5
通讯作者：
Gelmon, K. A.
中科院分区：
文献类型：
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作者：
Cardoso, F.;Harbeck, N.;Gelmon, K. A.
随着医疗需求的不断发展，以及我们对癌症生物学和恶性肿瘤治疗的理解不断提高，新的研究问题出现了。尽管在过去几十年中，乳腺癌研究的某些领域取得了重大进展，导致了治疗方法和结果的改善，但其他领域并没有同样受益，我们在知识上仍然存在许多差距。本文总结了被专家小组视为2016年优先事项的12项乳腺癌短期和中期临床研究需求，以期集中和加快未来在最需要的领域的研究：(I)在不牺牲结果的情况下降低早期乳腺癌的乳腺癌治疗；(Ii)探索最佳辅助治疗持续时间；(Iii)开发更好的工具和战略来识别有遗传易感性的患者；(Iv)改善年轻乳腺癌患者的护理；(V)开发工具以加快在生物标记物定义的人群中的药物开发；(Vi)确定和验证介导对化疗、内分泌治疗和抗HER2疗法的耐药性的靶点；(Vii)评估转移性疾病的局部区域治疗的疗效；(Viii)更好地确定转移环境中的最佳治疗顺序；(Ix)评估患者内部的异质性(肿瘤内、肿瘤间和病变间的异质性)的临床影响；(X)更好地了解生物学，并在三阴性乳腺癌中确定新的靶点；(Xi)更好地了解乳腺癌的免疫监测，进一步开发免疫疗法；以及(Xii)增加生存研究努力，包括支持护理和生活质量。
New research questions emerge as medical needs continue to evolve and as we improve our understanding of cancer biology and treatment of malignancies. Although significant advances have been made in some areas of breast cancer research resulting in improvements in therapies and outcomes over the last few decades, other areas have not benefited to the same degree and we continue to have many gaps in our knowledge. This article summarizes the 12 short and medium-term clinical research needs in breast cancer deemed as priorities in 2016 by a panel of experts, in an attempt to focus and accelerate future research in the most needed areas: (i) de-escalate breast cancer therapies in early breast cancer without sacrificing outcomes; (ii) explore optimal adjuvant treatment durations; (iii) develop better tools and strategies to identify patients with genetic predisposition; (iv) improve care in young patients with breast cancer; (v) develop tools to speed up drug development in biomarker-defined populations; (vi) identify and validate targets that mediate resistance to chemotherapy, endocrine therapy and anti-HER2 therapies; (vii) evaluate the efficacy of local-regional treatments for metastatic disease; (viii) better define the optimal sequence of treatments in the metastatic setting; (ix) evaluate the clinical impact of intra-patient heterogeneity (intratumor, inter-tumor and inter-lesion heterogeneity); (x) better understand the biology and identify new targets in triplenegative breast cancer; (xi) better understand immune surveillance in breast cancer and further develop immunotherapies; and (xii) increase survivorship research efforts including supportive care and quality of life.