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2017年6月17日，英国《柳叶刀》将正式发表英国伦敦大学癌症研究院、皇家马斯登医院、比利时鲁汶大学医院、德国乳腺研究组织、德国法兰克福血液学与肿瘤学中心、法国南巴黎大学（巴黎第十一大学）、古斯塔夫鲁西癌症中心的《柳叶刀》年度乳腺癌系列文章之一：晚期雌激素受体阳性乳腺癌治疗进展。 雌激素受体阳性乳腺癌是最常见的乳腺癌亚型。针对该亚型雌激素受体依赖性的内分泌疗法具有重要活性，但是耐药性的发生对于晚期癌症仍难以避免。雌激素受体阳性乳腺癌驱动因素和内分泌疗法耐药机制研究已经取得重大进展。该进展已经转化为晚期乳腺癌治疗的重大进展，包括加强内分泌疗法有效性的若干靶向疗法；mTOR抑制剂和细胞周期蛋白依赖型激酶CDK4和CDK6抑制剂可显著改善无进展生存。新一批靶向疗法正在被开发，包括PI3K、AKT、HER2的抑制剂，以及新一代雌激素受体降解剂。选择患者、决定最佳治疗顺序、确定疗法之间是否发生交叉耐药仍然存在相当大的挑战。 Lancet. 2017 Jun 17;389(10087):2403-2414. Advances in the treatment of advanced oestrogen-receptor-positive breast cancer. Turner NC, Neven P, Loibl S, Andre F. Royal Marsden Hospital and Institute of Cancer Research, London, UK; University Hospitals Leuven, Leuven, Belgium; German Breast Group (GBG), Neu-Isenburg, Germany; Centre for Haematology and Oncology, Frankfurt, Germany; Gustave Roussy Cancer Center, Université Paris Sud, Villejuif, France. Oestrogen-receptor-positive breast cancer is the most common subtype of breast cancer. Endocrine therapies that target the dependence of this subtype on the oestrogen receptor have substantial activity, yet the development of resistance to therapy is inevitable in advanced cancer. Major progress has been made in identifying the drivers of oestrogen-receptor-positive breast cancer and the mechanisms of resistance to endocrine therapy. This progress has translated into major advances in the treatment of advanced breast cancer, with several targeted therapies that enhance the efficacy of endocrine therapy; inhibitors of mTOR and inhibitors of the cyclin-dependent kinases CDK4 and CDK6 substantially improve progression-free survival. A new wave of targeted therapies is being developed, including inhibitors of PI3K, AKT, and HER2, and a new generation of oestrogen-receptor degraders. Considerable challenges remain in patient selection, deciding on the most appropriate order in which to administer therapies, and establishing whether cross-resistance occurs between therapies. PMID: 27939057 PII: S0140-6736(16)32419-9 DOI: 10.1016/S0140-6736(16)32419-9
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