Adjuvant and neoadjuvant therapy of ER+ / HER2– breast cancer
https://doi.org/10.33667/2078-5631-2021-31-7-12
Abstract
Even early-stage breast cancer is a heterogeneous disease, so the optimal treatment depends on the pathological characteristics of the tumor. The vast majority of breast tumors (80%) are classified as estrogen receptor positive (ER+) with varying degrees of ER expression. The benefit of endocrine therapy is small with low ER staining (1–10%), occurring in less than 2% of all cases of ER+ breast cancer. Genetic analyzes are valuable for administration of adjuvant chemotherapy prior to endocrine therapy in ER+ / HER2– pN0–pN1c breast cancer. But such tests are not yet widely available. In practical work, when planning adjuvant and neoadjuvant therapy for patients with ER+ / HER2– breast cancer, pathological assessment of the expression of ER, PR, Ki‑67, as well as the tumor grade (G) remains important. The use of drugs to overcome resistance to endocrine therapy: PI3-kinase inhibitors (taselisib), CDK 4/6 inhibitors (palbociclib, abemaciclib, ribociklib), mTOR inhibitors (everolimus) can enhance the effect of neoadjuvant and adjuvant endocrine therapy.
About the Authors
V. F. Semiglazov
National Medical Research Centre of Oncology n.a. N.N. Petrov
Russian Federation
Russian Federation
Semiglazov Vladimir F., DM Sci (habil.), professor, corresponding member of RAS, honored scientist, chairman of the St. Petersburg Society of Oncologists, professor at Dept of Oncology, head of Scientific Dept, senior researcher at Dept of Breast Tumor
Saint Petersburg
M. A. Dzhelialova
National Medical Research Centre of Oncology n.a. N.N. Petrov
Russian Federation
Russian Federation
Dzhelyalova Maryam A., oncologist at Clinical Diagnostic Dep
Saint Petersburg
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Review
For citations:
Semiglazov V.F., Dzhelialova M.A. Adjuvant and neoadjuvant therapy of ER+ / HER2– breast cancer. Medical alphabet. 2021;1(31):7-12. (In Russ.) https://doi.org/10.33667/2078-5631-2021-31-7-12
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