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Опухоли женской репродуктивной системы

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Гормонотерапия больных метастатическим раком молочной железы в пременопаузе: комбинации с ингибиторами циклинзависимых киназ

https://doi.org/10.17650/1994-4098-2019-15-2-30-41

Аннотация

В статье обсуждаются вопросы поиска наиболее эффективных стратегий терапии гормонозависимого HER2-отрицательного метастатического рака молочной железы в пременопаузе. До недавнего времени выключение яичников и последовательная гормонотерапия были основным видом лечения пациенток этой подгруппы. Появление палбоциклиба, названного «терапией прорыва», и впечатляющие результаты добавления ингибиторов циклинзависимых киназ 4 и 6 (CDK4/6) к режимам гормонотерапии у больных в менопаузе привели к необходимости оценки эффективности и безопасности данной стратегии в комбинации с овариальной супрессией у молодых пациенток.

Как показали результаты рандомизированных исследований и подгрупповых анализов, добавление ингибитора CDK4/6 к овариальной супрессии и гормональному препарату в соответствующей линии терапии приводит к существенному увеличению показателей выживаемости. Данные по безопасности соответствуют таковым у пациенток старшей возрастной группы. Рандомизированное исследование по сравнению комбинации палбоциклиб + овариальная супрессия + ингибитор ароматазы с химиотерапией у больных в пременопаузе показало достоверное превосходство новой стратегии: назначение ингибитора CDK4/6 в составе комплексного режима на 36 % снизило риск прогрессирования по сравнению с капецитабином.

Об авторах

Е. В. Артамонова
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России
Россия

Елена Владимировна Артамонова 

115478 Москва, Каширское шоссе, 24


Конфликт интересов: Статья подготовлена д.м.н. Е. В. Артамоновой при финансовой поддержке компании «Пфайзер». В статье выражена позиция автора, которая может отличаться от позиции компании «Пфайзер».


Е. И. Коваленко
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава России
Россия
115478 Москва, Каширское шоссе, 24


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Рецензия

Для цитирования:


Артамонова Е.В., Коваленко Е.И. Гормонотерапия больных метастатическим раком молочной железы в пременопаузе: комбинации с ингибиторами циклинзависимых киназ. Опухоли женской репродуктивной системы. 2019;15(2):30-41. https://doi.org/10.17650/1994-4098-2019-15-2-30-41

For citation:


Artamonova E.V., Kovalenko E.I. Hormone therapy for premenopausal women with metastatic breast cancer: combinations with cyclin-dependent kinase inhibitors. Tumors of female reproductive system. 2019;15(2):30-41. (In Russ.) https://doi.org/10.17650/1994-4098-2019-15-2-30-41

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ISSN 1994-4098 (Print)
ISSN 1999-8627 (Online)