Postmenopozal Kadınlarda Adjuvan Endokrin Tedavi
Özet
Kadınlarda en sık görülen meme kanserinin, %75 ini hormon pozitif grup oluşturmaktadır. Postmenopozol dönemde adjuvan endokrin tedavide birinci seçenek aromataz inhibitörleri olmalıdır. Rekürrens riski yüksek olan grupta endokrin tedavinin yanına CDK 4/6 inhibitör tedavisi eklenmesi hastalıksız sağkalım avantajı göstermiştir. Adjuvan kemoterapi almayan hastalarda endokrin tedavi operasyon sonrası 4-6 hafta içinde başlanmalıdır. Evre 1 meme kanserinde minimum beş yıl endokrin tedavisi verilmeli, yüksek riskli grupta endokrin tedavisi yedi ve/veya on yıla uzatılmalıdır.
Referanslar
NCCN Clinical Practice Guidelines in Oncology: Breast cancer. Version 4.2023.
Aromatase inhibitors in breast cancer, Smith IE, Dowsett M,N Engl J Med. 2003;348(24):2431
Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials.Early Breast Cancer Trialists' Collaborative Group (EBCTCG), Dowsett M, Forbes JF, Bradley R, Ingle J, Aihara T, Bliss J, Boccardo F, Coates A, Coombes RC, Cuzick J, Dubsky P, Gnant M, Kaufmann M, Kilburn L, Perrone F, Rea D, Thürlimann B, van de Velde C, Pan H, Peto R, Davies C, Gray R,Lancet. 2015;386(10001):1341. Epub 2015 Jul 23.
Adjuvant anastrozole versus exemestane versus letrozole, upfront or after 2 years of tamoxifen, in endocrine-sensitive breast cancer (FATA-GIM3): a randomised, phase 3 trial,De Placido S, Gallo C, De Laurentiis M, Bisagni G, Arpino G, Sarobba MG, Riccardi F, Russo A, Del Mastro L, Cogoni AA, Cognetti F, Gori S, Foglietta J, Frassoldati A, Amoroso D, Laudadio L, Moscetti L, Montemurro F, Verusio C, Bernardo A, Lorusso V, Gravina A, Moretti G, Lauria R, Lai A, Mocerino C, Rizzo S, Nuzzo F, Carlini P, Perrone F, GIM Investigators ,Lancet Oncol. 2018;19(4):474. Epub 2018 Feb 23
Patient-reported symptoms and discontinuation of adjuvant aromatase inhibitor therapy. Kidwell KM, Harte SE, Hayes DF, Storniolo AM, Carpenter J, Flockhart DA, Stearns V, Clauw DJ, Williams DA, Henry NL Cancer. 2014 Aug;120(16):2403-11. Epub 2014 May 6.
Prospective characterization of musculoskeletal symptoms in early stage breast cancer patients treated with aromatase inhibitors.Henry NL, Giles JT, Ang D, Mohan M, Dadabhoy D, Robarge J, Hayden J, Lemler S, Shahverdi K, Powers P, Li L, Flockhart D, Stearns V, Hayes DF, Storniolo AM, Clauw DJ Breast Cancer Res Treat. 2008;111(2):365. Epub 2007 Oct
Aromatase inhibitor-associated arthralgia and/ or bone pain: frequency and characterization in non-clinical trial patients. Presant CA, Bosserman L, Young T, Vakil M, Horns R, Upadhyaya G, Ebrahimi B, Yeon C, Howard F Clin Breast Cancer. 2007;7(10):775.
Exercise adherence in a randomized trial of exercise on aromatase inhibitor arthralgias in breast cancer survivors: the Hormones and Physical Exercise (HOPE) study. Arem H, Sorkin M, Cartmel B, Fiellin M, Capozza S, Harrigan M, Ercolano E, Zhou Y, Sanft T, Gross C, Schmitz K, Neogi T, Hershman D, Ligibel J, Irwin ML J Cancer Surviv. 2016;10(4):654. Epub 2016 Jan 19.
Predictors of aromatase inhibitor discontinuation as a result of treatment-emergent symptoms in early-stage breast cancer. Henry NL, Azzouz F, Desta Z, Li L, Nguyen AT, Lemler S, Hayden J, Tarpinian K, Yakim E, Flockhart DA, Stearns V, Hayes DF, Storniolo AM, J Clin Oncol. 2012 Mar;30(9):936-42. Epub 2012 Feb
Randomized, Multicenter, Placebo-Controlled Clinical Trial of Duloxetine Versus Placebo for Aromatase Inhibitor-Associated Arthralgias in Early-Stage Breast Cancer: SWOG S1202. Henry NL, Unger JM, Schott AF, Fehrenbacher L, Flynn PJ, Prow DM, Sharer CW, Burton GV, Kuzma CS, Moseley A, Lew DL, Fisch MJ, Moinpour CM, Hershman DL, Wade JL 3rd J Clin Oncol. 2018;36(4):326. Epub 2017 Nov 14.
Sexual dysfunction in women on adjuvant endocrine therapy after breast cancer. Baumgart J, Nilsson K, Evers AS, Kallak TK, Poromaa IS Menopause. 2013;20(2):162.
Aromatase inhibitors and bone. Eastell R J Steroid Biochem Mol Biol. 2007;106(1-5):157.
Effects of third generation aromatase inhibitors on bone health and other safety parameters: results of an open, randomised, multi-centre study of letrozole, exemestane and anastrozole in healthy postmenopausal women. McCloskey EV, Hannon RA, Lakner G, Fraser WD, Clack G, Miyamoto A, Finkelman RD, Eastell R,Eur J Cancer. 2007;43(17):2523.
Effect of anastrozole on bone mineral density: 5-year results from the anastrozole, tamoxifen, alone or in combination trial 18233230. Eastell R, Adams JE, Coleman RE, Howell A, Hannon RA, Cuzick J, Mackey JR, Beckmann MW, Clack G J Clin Oncol. 2008;26(7):1051.
The impact of bone mineral density screening on incident fractures and healthcare resource utilization among postmenopausal breast cancer survivors treated with aromatase inhibitors. Bailey S, Mhango G, Lin JJ, Osteoporos Int. 2022;33(9):1989. Epub 2022 Jun
Exercise effects on bone mineral density in women with breast cancer receiving adjuvant chemotherapy. Schwartz AL, Winters-Stone K, Gallucci B ,Oncol Nurs Forum. 2007;34(3):627.
Long term adjuvant endocrine therapy and risk of cardiovascular disease in female breast cancer survivors: systematic review,Matthews A, Stanway S, Farmer RE, Strongman H, Thomas S, Lyon AR, Smeeth L, Bhaskaran K,BMJ. 2018;363:k3845. Epub 2018 Oct 8.
Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2-, Node-Positive, High-Risk, Early Breast Cancer (monarchE). Johnston SRD, Harbeck N, Hegg R, Toi M, Martin M, Shao ZM, Zhang QY, Martinez Rodriguez JL, Campone M, Hamilton E, Sohn J, Guarneri V, Okada M, Boyle F, Neven P, Cortés J, Huober J, Wardley A, Tolaney SM, Cicin I, Smith IC, Frenzel M, Headley D, Wei R, San Antonio B, Hulstijn M, Cox J, O'Shaughnessy J, Rastogi P, monarchE Committee Members and Investigators J Clin Oncol. 2020;38(34):3987. Epub 2020 Sep 20.
Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer-Cyclin-Dependent Kinase 4 and 6 Inhibitors: ASCO Guideline Rapid Recommendation Update. Freedman RA, Caswell-Jin JL, Hassett M, Somerfield MR, Giordano SH, Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer Guideline Expert Panel J Clin Oncol. 2024;42(18):2233. Epub 2024 May 20.
Adjuvant Olaparib for Patients with BRCA1- or BRCA2-Mutated Breast Cancer. Tutt ANJ, Garber JE, Kaufman B, Viale G, Fumagalli D, Rastogi P, Gelber RD, de Azambuja E, Fielding A, Balmaña J, Domchek SM, Gelmon KA, Hollingsworth SJ, Korde LA, Linderholm B, Bandos H, Senkus E, Suga JM, Shao Z, Pippas AW, Nowecki Z, Huzarski T, Ganz PA, Lucas PC, Baker N, Loibl S, McConnell R, Piccart M, Schmutzler R, Steger GG, Costantino JP, Arahmani A, Wolmark N, McFadden E, Karantza V, Lakhani SR, Yothers G, Campbell C, Geyer CE Jr, OlympiA Clinical Trial Steering Committee and Investigators,N Engl J Med. 2021;384(25):2394. Epub 2021 Jun 3.
Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Davies C, Pan H, Godwin J, Gray R, Arriagada R, Raina V, Abraham M, Medeiros Alencar VH, Badran A, Bonfill X, Bradbury J, Clarke M, Collins R, Davis SR, Delmestri A, Forbes JF, Haddad P, Hou MF, Inbar M, Khaled H, Kielanowska J, Kwan WH, Mathew BS, Mittra I, Müller B, Nicolucci A, Peralta O, Pernas F, Petruzelka L, Pienkowski T, Radhika R, Rajan B, Rubach MT, Tort S, Urrútia G, Valentini M, Wang Y, Peto R, Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) Collaborative Group,Lancet. 2013;381(9869):805.
Longer-term outcomes of letrozole versus placebo after 5 years of tamoxifen in the NCIC CTG MA.17 trial: analyses adjusting for treatment crossover. Jin H, Tu D, Zhao N, Shepherd LE, Goss PE ,J Clin Oncol. 2012;30(7):718. Epub 2011 Oct 31.
Extending Aromatase-Inhibitor Adjuvant Therapy to 10 Years. Goss PE, Ingle JN, Pritchard KI, Robert NJ, Muss H, Gralow J, Gelmon K, Whelan T, Strasser-Weippl K, Rubin S, Sturtz K, Wolff AC, Winer E, Hudis C, Stopeck A, Beck JT, Kaur JS, Whelan K, Tu D, Parulekar WR.N Engl J Med. 2016;375(3):209. Epub 2016 Jun 5.
Duration of Adjuvant Aromatase-Inhibitor Therapy in Postmenopausal Breast Cancer. Gnant M, Fitzal F, Rinnerthaler G, Steger GG, Greil-Ressler S, Balic M, Heck D, Jakesz R, Thaler J, Egle D, Manfreda D, Bjelic-Radisic V, Wieder U, Singer CF, Melbinger-Zeinitzer E, Haslbauer F, Sevelda P, Trapl H, Wette V, Wimmer K, Gampenrieder SP, Bartsch R, Kacerovsky-Strobl S, Suppan C, Brunner C, Deutschmann C, Soelkner L, Fesl C, Greil R, Austrian Breast and Colorectal Cancer Study Group,N Engl J Med. 2021;385(5):395.
Adjuvant chemotherapy and timing of tamoxifen in postmenopausal patients with endocrine-responsive, node-positive breast cancer: a phase 3, open-label, randomised controlled trial. Albain KS, Barlow WE, Ravdin PM, Farrar WB, Burton GV, Ketchel SJ, Cobau CD, Levine EG, Ingle JN, Pritchard KI, Lichter AS, Schneider DJ, Abeloff MD, Henderson IC, Muss HB, Green SJ, Lew D, Livingston RB, Martino S, Osborne CK, Breast Cancer Intergroup of North America Lancet.2009;374(9707):2055. Epub 2009 Dec 10.
Association of Endocrine Therapy for HR+/ERBB2+ Metastatic Breast Cancer With Survival Outcomes. Carausu M, Carton M, Diéras V, Petit T, Guiu S, Gonçalves A, Augereau P, Ferrero JM, Levy C, Ung M, Desmoulins I, Debled M, Bachelot T, Pistilli B, Frenel JS, Mailliez A, Chevrot M, Cabel L JAMA Netw Open. 2022;5(12):e2247154. Epub 2022 Dec 1.
Efficacy of adjuvant aromatase inhibitor in hormone receptor-positive postmenopausal breast cancer patients according to the body mass index. Sendur MA, Aksoy S, Zengin N, Altundag K,Br J Cancer. 2012 Nov;107(11):1815-9. Epub 2012 Oct 25.
Outcomes of special histotypes of breast cancer after adjuvant endocrine therapy with letrozole or tamoxifen in the monotherapy cohort of the BIG 1-98 trial. Munzone E, Giobbie-Hurder A, Gusterson BA, Mallon E, Viale G, Thürlimann B, Ejlertsen B, MacGrogan G, Bibeau F, Lelkaitis G, Price KN, Gelber RD, Coates AS, Goldhirsch A, Colleoni M, International Breast Cancer Study Group and the BIG 1-98 Collaborative Group Ann Oncol. 2015 Dec;26(12):2442-9. Epub 2015 Sep 19.