РОЛЬ "ТЕСТОВОГО" КУРСА ПРЕДОПЕРАЦИОННОЙ ГОРМОНОТЕРАПИИ В ВЫБОРЕ ТАКТИКИ ЛЕЧЕНИЯ ПЕРВИЧНО-ОПЕРАБЕЛЬНОГО ГОРМОНОЗАВИСИМОГО НЕЫ2-НЕГАТИВНОГО РАКА МОЛОЧНОЙ ЖЕЛЕЗЫстатьяИсследовательская статья
Аннотация:In the absence of widespread access to genomic tests there is an urgent need for additional methods that influence the choice of adjuvant therapy in patients with early luminal Her2-negative subtype of breast cancer (BC). The IMPACT and POETIC trials have shown that Ki67 level decrease up to <10% after a “short-term” (2-4 weeks) preoperative endocrine therapy (ET) is a favorable prognostic factor. This test allows some patients to avoid adjuvant chemotherapy associated with immediate and delayed adverse events. Aims of the study. To evaluate the impact of “short-term” preoperative endocrine therapy for guidance of further treatment for patients with primary operable luminal Her2-negative breast cancer stages Tl-3 N0-1 MO.Results. The study included 123 patients, 76 (60.8%) received tamoxifen and47 (37.6%) - aromatase inhibitors (Al). Most patients-69 (55.2%) were >50 years old, premenopausal - 58 (46.4%), menopausal-67 (53.6%). The average age was 52 years (30-82). With the initial Ki67 level> 10% (N= 107), Ki67 decreased in 24 (22.4%) up to <10% after “short-term” ET, and remained >10% in 83 (77.6%). According to the PREDICT calculator, the benefit of adjuvant chemotherapy (AChT) was assessed as high in 35 (28.5%) patients, and 10 of them (27.8%) were able to avoid Ch T. In 86 patients with a relatively low estimated AC hT benefit (<5% at lOyears) there was noresponse to “short-term" ET, which led to the AChT prescription in 13 cases (15.1%). Conc/us/ons. “Short-term” course of preoperative endocrine therapy 'is a simple, accessible and reproducible method for personalizing of adjuvant therapy in patients with luminal HER2-negafive breast cancer.
