Combination of Modern Radiotherapy and New Targeted Treatments for Breast Cancer Management.
Combination of Modern Radiotherapy and New Targeted Treatments for Breast Cancer Management.
复制标题
DOI：
10.3390/cancers13246358
复制
发表时间：
2021-12-18
期刊：
影响因子：
5.2
通讯作者：
Kirova Y
中科院分区：
文献类型：
--
作者：
Beddok A;Cottu P;Fourquet A;Kirova Y
自从三十年前引入激素疗法治疗乳腺癌以来，已经开发了许多新的靶向治疗方法。其中一些目前正在使用，如HER2抑制剂，而另一些仍在开发中，如细胞周期(CDK)抑制剂、免疫检查点(PD1/PDL1)抑制剂或作用于DNA损伤(PARP)修复的分子。此外，放射治疗(RT)通常用于乳腺癌保乳手术后早期乳腺癌的辅助治疗，或用于转移部位的姑息性治疗。我们的研究表明，最常用的靶向治疗和RT的组合是可行的，但毒性很小。然而，关于这一主题的大部分知识都是基于回溯性研究，少数患者和护理应该在这种情况下进行，直到这些结果在前瞻性随机研究中得到证实。背景：本研究的目的是回顾关于最常用或正在开发的靶向治疗和放射治疗(RT)组合的基本知识。方法：广泛回顾研究这一组合的临床前和临床研究。结果：多项研究表明，RT和他莫昔芬的联合应用增加了放射性肺毒性的风险；因此，这两种方法不应同时给予。HER2抑制剂(曲妥珠单抗、pertuzumab)与RT联合应用似乎是安全的。然而，曲妥珠单抗(T-DM1)不应与脑放疗同时使用，因为这种联合使用可能会增加脑放射性坏死的风险。RT和其他新的靶向治疗的组合，如选择性雌激素受体降解剂、拉帕替尼、细胞周期抑制剂、免疫检查点抑制剂或作用于DNA损伤修复的分子似乎是可行的，但基本上是通过对少数患者的回顾性或前瞻性研究进行评估。此外，这些研究在辐射剂量和分割、药物剂量和使用的治疗顺序方面存在相当大的异质性。结论：RT与大多数靶向治疗相结合治疗BC似乎耐受性良好，但这些结果需要在前瞻性随机研究中得到证实。
Since the introduction of hormone therapy for the treatment of breast cancer (BC) three decades ago, many new targeted therapies have been developed. Some of them are currently used, such as HER2 inhibitors, while others are still under development, such as cell cycle (CDK) inhibitors, immune checkpoint (PD1/PDL1) inhibitors, or molecules acting on DNA damage (PARP) repair. Besides this, radiation therapy (RT) is commonly used either as adjuvant treatment for early BC after breast conservative surgery or in palliative intent for the treatment of metastatic sites. Our research has shown that the combinations of the most commonly used targeted treatments and RT were feasible with a few toxicities. Nevertheless, most of the knowledge on this subject is based on retrospective studies and a small number of patients and care should be taken in this setting until these results would be confirmed in prospective randomized studies. Background: The objective of the present study was to review the essential knowledge about the combinations of the most commonly used or under development targeted treatments and radiation therapy (RT). Methods: Preclinical and clinical studies investigating this combination were extensively reviewed. Results: Several studies showed that the combination of RT and tamoxifen increased the risk of radiation-induced pulmonary toxicity; therefore, both modalities should not be given concomitantly. The combination of HER2 inhibitors (trastuzumab, pertuzumab) and RT seems to be safe. However, trastuzumab emtansine (T-DM1) should not be administered concurrently with brain RT since this combination could increase the risk of brain radionecrosis. The combination of RT and other new target treatments such as selective estrogen receptor degradants, lapatinib, cell cycle inhibitors, immune checkpoint inhibitors, or molecules acting on DNA damage repair seems feasible but was essentially evaluated on retrospective or prospective studies with a small number of patients. Furthermore, there is considerable heterogeneity among these studies regarding the dose and fractionation of radiation, the dosage of drugs, and the sequence of treatments used. Conclusions: The combination of RT with most targeted therapies for BC appears to be well-tolerated, but these results need to be confirmed in prospective randomized studies.
登录
查看更多内容
影响因子：
3.7
作者：
Clement-Zhao, Alice;Tanguy, Marie-Laure;Kirova, Youlia
通讯作者：
Kirova, Youlia
影响因子：
51.1
作者：
Azria, David;Belkacemi, Yazid;Ozsahin, Mahmut
通讯作者：
Ozsahin, Mahmut
影响因子：
5.7
作者：
Bollet, Marc A.;Kirova, Youlia M.;Fourquet, Alain
通讯作者：
Fourquet, Alain
影响因子：
5.2
作者：
Aboudaram A;Loap P;Loirat D;Dhia SB;Cao K;Fourquet A;Kirova Y
通讯作者：
Kirova Y
影响因子：
2.4
作者：
Anzic M;Marinko T
通讯作者：
Marinko T