Неоадъювантное лечение рака молочной железы

Клинические испытания показали, что состояние женщин, у которых достигнут полный патоморфологический регресс опухоли (рCR), характеризуется существенным улучшением показателей выживаемости по сравнению с теми, у кого он не достигнут в столь выраженной степени. Достижение pCR как промежуточного маркера улучшения выживаемости наблюдается в основном у женщин с агрессивными подтипами рака молочной железы (РМЖ): трижды негативным и HER-2-позитивным. У пациенток с HER-2-позитивным РМЖ добавление трастузумаба к неоадъювантной химиотерапии удваивает частоту рCR и коррелирует с повышением показателей выживаемости. Проведенные клинические испытания установили, что у больных с высокой экспрес- сией рецепторов стероидных гормонов наиболее подходящим лечением является неоадъювантная эндокринотерапия. Исследует- ся возможность ее применения в комбинации с таргетной (анти-HER) терапией при коэкспрессии эстрогена и HER-2. Неоадъ- ювантная терапия при подходящих стадиях РМЖ позволяет ускорить оценку новых лекарственных средств с помощью идентификации предикативных (предсказывающих) биологических маркеров ответа (в частности, показателя pCR). Хотя стандартная неоадъювантная терапия приносит явную пользу пациенткам с pCR, остальные больные с так называемым рези- дуальным заболеванием находятся в зоне высокого риска рецидива.

рак молочной железы, неоадъювантная терапия

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