激素受体阳性/HER2阴性早期乳腺癌内分泌治疗研究进展OA
Research Advances in Endocrine Therapy for Hormone Receptor-Positive/HER2-Negative Early Breast Cancer
激素受体(HR)阳性/HER2阴性是早期乳腺癌最常见的亚型,内分泌治疗是其辅助治疗的基石.近年来,随着SOFT、TEXT、monarchE等关键研究结果的公布,以及以lidERA研究为代表的新药探索取得突破,HR阳性/HER2阴性早期乳腺癌的内分泌治疗策略正朝着更加精准和强化的方向发展.本文系统综述了该领域的最新进展,重点包括卵巢功能抑制(OFS)在绝经前高危患者中标准地位的巩固及其长期随访证据;延长内分泌治疗疗程的获益与风险评估;CDK4/6抑制剂在辅助治疗中的应用现状及不同药物间的差异.同时,探讨了当前治疗面临的问题与挑战,如治疗相关生活质量的优化与获益人群的精准筛选,并简要介绍了口服选择性雌激素受体降解剂(SERD)等新型药物的临床研究进展.此外,针对年轻患者的特殊需求,概述了化疗期间卵巢功能保护与生育力保存策略的循证医学依据.本文旨在为临床实践提供全面参考,协助临床医师在追求疗效最大化的同时,更好地平衡患者的长期生活质量和个体化需求.
Hormone receptor(HR)-positive/HER2-negative early breast cancer is the most common subtype of breast cancer,and endocrine therapy serves as the cornerstone of adjuvant treatment.In recent years,with the publication of key clinical trials such as SOFT,TEXT,and monarchE,and breakthroughs in novel agents studies like lidERA,the endocrine therapy strategy for HR-positive/HER2-negative early breast cancer has evolved toward increased precision and intensity.This article systematically reviews the latest advances in endocrine therapy,focusing on the consolidation of ovarian function suppression as a standard for high-risk premenopausal patients with updated follow-up evidence,the benefit-risk assessment of extended endocrine therapy,and the current application and interdrug differences of CDK4/6 inhibitors in the adjuvant setting.This manuscript also addresses existing challenges,including optimizing treatment-related quality of life and precisely identifying beneficiary populations,and briefly introduces the clinical trial progress of novel agents,such as oral selective estrogen receptor degraders.Furthermore,it outlines evidence-based strategies for ovarian protection during chemotherapy and fertility preservation for young patients.This review aims to provide clinicians with a comprehensive perspective,balancing the pursuit of maximal efficacy with patients'long-term quality of life and individualized needs.
黄文钦;杨亚龙;吴新红;Matteo LAMBERTINI;郑红梅
430079 武汉,湖北省肿瘤医院(华中科技大学同济医学院附属湖北肿瘤医院)乳腺中心,国家临床重点专科建设学科,湖北省乳腺癌临床医学研究中心,武汉市乳腺癌临床医学研究中心430079 武汉,湖北省肿瘤医院(华中科技大学同济医学院附属湖北肿瘤医院)乳腺中心,国家临床重点专科建设学科,湖北省乳腺癌临床医学研究中心,武汉市乳腺癌临床医学研究中心430079 武汉,湖北省肿瘤医院(华中科技大学同济医学院附属湖北肿瘤医院)乳腺中心,国家临床重点专科建设学科,湖北省乳腺癌临床医学研究中心,武汉市乳腺癌临床医学研究中心16132 热那亚,IRCCS圣马蒂诺医院综合医院肿瘤内科||16132 热那亚,热那亚大学医学院内科学与医学专科系430079 武汉,湖北省肿瘤医院(华中科技大学同济医学院附属湖北肿瘤医院)乳腺中心,国家临床重点专科建设学科,湖北省乳腺癌临床医学研究中心,武汉市乳腺癌临床医学研究中心
医药卫生
乳腺肿瘤激素受体阳性人表皮生长因子受体2内分泌治疗卵巢功能抑制CDK4/6抑制剂卵巢保护生育力保存
Breast neoplasmsHormone receptor positiveHER2Endocrine therapyOvarian function suppressionCDK4/6 inhibitorOvarian protectionFertility preservation
《肿瘤防治研究》 2026 (3)
169-175,7
Talent Project of Hubei Cancer Hospital(No.2025HBCHLHRC002No.2025HBCHHHRC005No.2025HBCHQHRC018)Chutian Talent Project(No.CTYC002)Wu Jieping Fund Project(No.320.6750.2024-21-5No.320.6750.2025-21-13)Hubei Province Medical Youth Talent Program(No.Eweitong[2023]65)National Key Specialized Construction Project(No.HBCHBBC-A01)Hubei Cancer Hospital Intramural Research Program(No.2025HBCHYN24No.2025HBCHYN35) 湖北省肿瘤医院人才项目(2025HBCH-LHRC0022025HBCHHHRC0052025HBCHQHRC018)楚天英才项目(CTYC002)吴阶平基金(320.6750.2024-21-5320.6750.2025-21-13)湖北省医学青年拔尖人才项目(鄂卫通[2023]65号)湖北省肿瘤医院乳腺癌国家临床重点专科建设项目(HBCHBBC-A01)湖北省肿瘤医院院内科研项目(2025HBCHYN242025HBCHYN35)
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