ASCO乳腺癌內(nèi)分泌治療與骨保護進展陳占紅學習教案

1、會計學1ASCO乳腺癌內(nèi)分泌治療與骨保護進展陳占乳腺癌內(nèi)分泌治療與骨保護進展陳占紅紅HER-2/ER專場專場第1頁/共67頁內(nèi)容內(nèi)容 LBA500LBA500：NSABP B-35NSABP B-35關(guān)于絕經(jīng)后關(guān)于絕經(jīng)后DCISDCIS采取采取“腫塊切除腫塊切除+ +放療放療” 常規(guī)治療基礎上，內(nèi)分泌治療選擇常規(guī)治療基礎上，內(nèi)分泌治療選擇TAMTAM和阿那曲唑何者更優(yōu)？和阿那曲唑何者更優(yōu)？1 A501A501：CALGB40503CALGB40503關(guān)于絕經(jīng)后激素受體陽性乳腺癌一關(guān)于絕經(jīng)后激素受體陽性乳腺癌一線選擇來曲唑單藥或聯(lián)合貝伐單抗的線選擇來曲唑單藥或聯(lián)合貝伐單抗的期臨床研究；期臨床研究

2、；234LBA502LBA502：PALOMA3PALOMA3是對于激素受體陽性晚期乳腺癌內(nèi)分泌解救選擇氟維司群是對于激素受體陽性晚期乳腺癌內(nèi)分泌解救選擇氟維司群500mg500mg基礎加或不加基礎加或不加CDK4/6CDK4/6抑制劑抑制劑palbociclibpalbociclib的的期臨床研究；期臨床研究；A503-504A503-504：早期乳腺癌輔助雙膦酸鹽或地諾單抗（早期乳腺癌輔助雙膦酸鹽或地諾單抗（denosumabdenosumab）治療）治療期臨床研究期臨床研究(S0307(S0307和和ABCSG-18);ABCSG-18);第2頁/共67頁Presented By Eri

3、c Winer at 2015 ASCO Annual Meeting第3頁/共67頁Presented By Eric Winer at 2015 ASCO Annual Meeting主要研究終點：BCFI第4頁/共67頁Presented By Eric Winer at 2015 ASCO Annual Meeting分層分析第5頁/共67頁Presented By Eric Winer at 2015 ASCO Annual Meeting次要研究終點：OS第6頁/共67頁Presented By Eric Winer at 2015 ASCO Annual Meeting第7頁/共

4、67頁Presented By Eric Winer at 2015 ASCO Annual Meeting第8頁/共67頁內(nèi)容內(nèi)容 LBA500LBA500：NSABP B-35NSABP B-35關(guān)于絕經(jīng)后關(guān)于絕經(jīng)后DCISDCIS采取采取“腫塊切除腫塊切除+ +放療放療” 常規(guī)治療基礎上，內(nèi)分泌治療選擇常規(guī)治療基礎上，內(nèi)分泌治療選擇TAMTAM和阿那曲唑何者更優(yōu)？和阿那曲唑何者更優(yōu)？1 A501A501：CALGB40503CALGB40503關(guān)于絕經(jīng)后激素受體陽性乳腺癌一關(guān)于絕經(jīng)后激素受體陽性乳腺癌一線選擇來曲唑單藥或聯(lián)合貝伐單抗的線選擇來曲唑單藥或聯(lián)合貝伐單抗的期臨床研究；期臨床研究

5、；234LBA502LBA502：PALOMA3PALOMA3是對于激素受體陽性晚期乳腺癌內(nèi)分泌解救選擇氟維司群是對于激素受體陽性晚期乳腺癌內(nèi)分泌解救選擇氟維司群500mg500mg基礎加或不加基礎加或不加CDK4/6CDK4/6抑制劑抑制劑palbociclibpalbociclib的的期臨床研究；期臨床研究；A503-504A503-504：早期乳腺癌輔助雙膦酸鹽或地諾單抗（早期乳腺癌輔助雙膦酸鹽或地諾單抗（denosumabdenosumab）治療）治療期臨床研究期臨床研究(S0307(S0307和和ABCSG-18);ABCSG-18);第9頁/共67頁Presented By Mau

6、ra Dickler at 2015 ASCO Annual Meeting第10頁/共67頁Presented By Joseph Sparano at 2015 ASCO Annual Meeting第11頁/共67頁分層：1.可測量病灶（有/無）2. 無病間隔（24月/24月）主要研究終點：PFS次要研究終點：OS，ORR，CBR，治療相關(guān)毒性事件隨機，開放，多中心，III期臨床評估晚期一線乳腺癌使用來曲唑+/-貝伐單抗第12頁/共67頁第13頁/共67頁Presented By Maura Dickler at 2015 ASCO Annual Meeting基線特征（1）第14頁/共

7、67頁Presented By Maura Dickler at 2015 ASCO Annual Meeting基線特征（2）第15頁/共67頁Presented By Maura Dickler at 2015 ASCO Annual MeetingPFS：從入組研究至首次疾病進展或任何原因的死亡主要研究終點：PFS中位隨訪時間：39月（范圍0.8-70月）第16頁/共67頁Presented By Maura Dickler at 2015 ASCO Annual Meeting亞組分析第17頁/共67頁Presented By Maura Dickler at 2015 ASCO An

8、nual Meeting次要研究終點：OS第18頁/共67頁Presented By Maura Dickler at 2015 ASCO Annual Meeting第19頁/共67頁Presented By Maura Dickler at 2015 ASCO Annual Meeting第20頁/共67頁Presented By Maura Dickler at 2015 ASCO Annual Meeting第21頁/共67頁Presented By Maura Dickler at 2015 ASCO Annual Meeting第22頁/共67頁第23頁/共67頁內(nèi)容內(nèi)容 LBA5

9、00LBA500：NSABP B-35NSABP B-35關(guān)于絕經(jīng)后關(guān)于絕經(jīng)后DCISDCIS采取采取“腫塊切除腫塊切除+ +放療放療” 常規(guī)治療基礎上，內(nèi)分泌治療選擇常規(guī)治療基礎上，內(nèi)分泌治療選擇TAMTAM和阿那曲唑何者更優(yōu)？和阿那曲唑何者更優(yōu)？1 A501A501：CALGB40503CALGB40503關(guān)于絕經(jīng)后激素受體陽性乳腺癌一關(guān)于絕經(jīng)后激素受體陽性乳腺癌一線選擇來曲唑單藥或聯(lián)合貝伐單抗的線選擇來曲唑單藥或聯(lián)合貝伐單抗的期臨床研究；期臨床研究；234LBA502LBA502：PALOMA3PALOMA3是對于激素受體陽性晚期乳腺癌內(nèi)分泌解救選擇氟維司群是對于激素受體陽性晚期乳腺癌內(nèi)

10、分泌解救選擇氟維司群500mg500mg基礎加或不加基礎加或不加CDK4/6CDK4/6抑制劑抑制劑palbociclibpalbociclib的的期臨床研究；期臨床研究；A503-504A503-504：早期乳腺癌輔助雙膦酸鹽或地諾單抗（早期乳腺癌輔助雙膦酸鹽或地諾單抗（denosumabdenosumab）治療）治療期臨床研究期臨床研究(S0307(S0307和和ABCSG-18);ABCSG-18);第24頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual Meeting第25頁/共67頁Presented By Nicholas

11、 Turner at 2015 ASCO Annual Meeting第26頁/共67頁CDK=cyclin-dependent kinase第27頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual MeetingHR+ HER2- 晚期乳腺癌絕經(jīng)前，圍絕經(jīng)*，絕經(jīng)后之前內(nèi)分泌治療進展輔助期間或者結(jié)束12個內(nèi)晚期乳腺癌治療期間1線的針對晚期腫瘤的化療*絕經(jīng)前圍絕經(jīng)均使用戈舍瑞林內(nèi)臟轉(zhuǎn)移之前治療的敏感性絕技前/圍絕經(jīng) vs 絕經(jīng)后絕經(jīng)后患者必須是之前AI治療進展的患者首要終點： PFS 次要終點：CBR，ORR，OS，安全性，標記物，Qo

12、L第28頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual Meeting基線腫瘤特征第29頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual Meeting腫瘤特征和前期治療第30頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual Meeting治療情況匯總第31頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual Meeting第32頁/共67頁Presented

13、 By Nicholas Turner at 2015 ASCO Annual Meeting第33頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual Meeting次要療效終點匯總第34頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual Meeting不良反應第35頁/共67頁Presented By Nicholas Turner at 2015 ASCO Annual Meeting第36頁/共67頁第37頁/共67頁內(nèi)容內(nèi)容 LBA500LBA500：NSABP B-35

14、NSABP B-35關(guān)于絕經(jīng)后關(guān)于絕經(jīng)后DCISDCIS采取采取“腫塊切除腫塊切除+ +放療放療” 常規(guī)治療基礎上，內(nèi)分泌治療選擇常規(guī)治療基礎上，內(nèi)分泌治療選擇TAMTAM和阿那曲唑何者更優(yōu)？和阿那曲唑何者更優(yōu)？1 A501A501：CALGB40503CALGB40503關(guān)于絕經(jīng)后激素受體陽性乳腺癌一關(guān)于絕經(jīng)后激素受體陽性乳腺癌一線選擇來曲唑單藥或聯(lián)合貝伐單抗的線選擇來曲唑單藥或聯(lián)合貝伐單抗的期臨床研究；期臨床研究；234LBA502LBA502：PALOMA3PALOMA3是對于激素受體陽性晚期乳腺癌內(nèi)分泌解救選擇氟維司群是對于激素受體陽性晚期乳腺癌內(nèi)分泌解救選擇氟維司群500mg500m

15、g基礎加或不加基礎加或不加CDK4/6CDK4/6抑制劑抑制劑palbociclibpalbociclib的的期臨床研究；期臨床研究；A503-504A503-504：早期乳腺癌輔助雙膦酸鹽或地諾單抗（早期乳腺癌輔助雙膦酸鹽或地諾單抗（denosumabdenosumab）治療）治療期臨床研究期臨床研究(S0307(S0307和和ABCSG-18);ABCSG-18);第38頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual Meeting第39頁/共67頁Presented By Robert Coleman at 2015 ASCO

16、Annual Meeting第40頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual Meeting第41頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual Meeting第42頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual Meeting第43頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual Meeting第44頁/共67頁Presented By Robert C

17、oleman at 2015 ASCO Annual Meeting第45頁/共67頁Presented By Michael Gnant at 2015 ASCO Annual Meeting第46頁/共67頁Presented By Michael Gnant at 2015 ASCO Annual Meeting第47頁/共67頁Presented By Michael Gnant at 2015 ASCO Annual Meeting第48頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual Meeting第49頁/共67頁Pres

18、ented By Robert Coleman at 2015 ASCO Annual Meeting第50頁/共67頁Presented By Michael Gnant at 2015 ASCO Annual Meeting第51頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual Meeting第52頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual MeetingI-III 期乳腺癌第53頁/共67頁Presented By Robert Coleman at 2015 ASC

19、O Annual Meeting第54頁/共67頁Presented By Julie Gralow at 2015 ASCO Annual Meeting第55頁/共67頁Presented By Julie Gralow at 2015 ASCO Annual Meeting第56頁/共67頁Presented By Julie Gralow at 2015 ASCO Annual Meeting第57頁/共67頁Presented By Julie Gralow at 2015 ASCO Annual Meeting第58頁/共67頁Presented By Julie Gralow a

20、t 2015 ASCO Annual Meeting第59頁/共67頁Presented By Julie Gralow at 2015 ASCO Annual Meeting第60頁/共67頁Presented By Robert Coleman at 2015 ASCO Annual Meeting第61頁/共67頁總結(jié)總結(jié) 1 234LBA502LBA502：PALOMA3 PALOMA3 對于激素受體陽性晚期乳腺癌內(nèi)分泌解救對于激素受體陽性晚期乳腺癌內(nèi)分泌解救治療：治療：氟維司群氟維司群500mg500mg結(jié)合結(jié)合palbociclibpalbociclib的方案的方案是是一種非常有效的治療選擇；一種非常有效的治療選擇；A503-504A503-504：早期乳腺癌輔助治療早期乳腺癌輔助治療不同類型不同類型雙膦酸鹽雙膦酸鹽無顯著差異，無顯著差異，地諾單抗地諾單抗可顯著降低接受可顯著降低接受 AI AI 治療的絕經(jīng)后乳腺癌患者的骨折次數(shù)并提高患者骨密度且安全性良好。治療的絕經(jīng)后乳腺癌患者的骨折次數(shù)并提高患者骨密度且安全性良好