Neoadjuvant treatment for early-stage breast cancer: opportunities to assess tumour response
Neoadjuvant treatment for early-stage breast cancer: opportunities to assess tumour response
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DOI：
10.1016/s1470-2045(06)70906-8
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发表时间：
2006-10-01
期刊：
影响因子：
51.1
通讯作者：
Smith, Ian E.
中科院分区：
文献类型：
--
作者：
Jones, Robin L.;Smith, Ian E.
20世纪70年代初，作为治疗不能手术的局部晚期乳腺癌的综合治疗方法的一部分，引入了初级、术前或新辅助化疗。该方法的结果是高反应和充分的降期，使一些患者可以进行乳房切除术。此外，还报道了少数病理完全应答者。逐渐地，术前化疗的想法被扩展到包括大型但可手术的早期乳腺癌患者，在某些情况下，有可能降低原发肿瘤的分期，以避免乳房切除，并允许进行保乳手术。这种方法允许将肿瘤用作体内治疗反应的衡量标准。最近，新辅助化疗的可能性已经打开，以提供有关临床、病理和分子终点的使用信息，这些终点可以用作替代标记物来预测辅助环境中的长期结果。此外，乳腺的解剖可及性为连续活检研究治疗过程中的分子变化提供了可能。
Primary, preoperative, or neoadjuvant chemotherapy was introduced in the early 1970s as part of an integrated therapeutic approach to treat inoperable locally advanced breast cancer. The approach resulted in high responses, and sufficient downstaging to allow mastectomy in some patients. In addition, a small number of pathological complete responders were reported. Gradually, the idea of preoperative chemotherapy was extended to include patients with large but operable early-stage breast cancer, with the possibility in some cases of downstaging the primary tumour to avoid mastectomy, and to allow breast-conserving surgery to be done. This approach allows the tumour to be used as a measure of treatment response in vivo. More recently, the possibility has opened up for neoadjuvant chemotherapy to provide information on the use of clinical, pathological, and molecular endpoints, which can be used as surrogate markers to predict long-term outcome in the adjuvant setting. In addition, the anatomical accessibility of the breast provides the potential for serial biopsies to investigate molecular changes during treatment.