Skip to main content
Log in

Les traitements adjuvants des cancers du sein : dernières avancées et perspectives pour des cancers très différents

Adjuvant treatments for breast cancer: Recent progress and new outlooks for different cancer types

  • Mise Au Point / Update
  • Published:
Oncologie

Résumé

Une part de plus en plus importante des cancers du sein est de stade localisé au diagnostic donc largement curable avec la combinaison des traitements locaux et des traitements systémiques adjuvants. Le choix précis de ces derniers (type, durée et modalités d’administration) ainsi que la décision de les administrer ou pas, en tenant compte de l’hétérogénéité tumorale des cancers du sein et de l’amélioration des connaissances de l’histoire naturelle de cette pathologie, mais aussi d’une discussion avec la femme concernée, rend compte d’une médecine de plus en plus personnalisée. Nous allons dans cet article passer en revue les changements récents, les questions d’actualités et les perspectives des traitements systémiques adjuvants des cancers du sein.

Abstract

The most significant part of breast cancers is the localised stage diagnosis, which are widely curable through a combination of topical and adjuvant systemic treatments. The specific choice of these adjuvant treatments (type, duration and route of administration), as well as the decision whether or not to give them, taking into account the heterogeneity of breast cancer tumours and the improvement in the understanding of the natural history of this disease, plus discussion with the woman, results in increasingly personalised medical treatment. In this article, we are going to review the recent changes, the questions that have arisen and the outlook for adjuvant systemic breast cancer treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. Sotiriou C, Neo SY, McShane LM, et al. (2003) Breast cancer classification and prognosis based on gene expression profiles from a population-based study. Proc Natl Acad Sci U S A 100: 10393–8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Early Breast Cancer Trialists’ Collaborative Group (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365: 1687–717

    Article  Google Scholar 

  3. Desmedt C, Haibe-Kains B, Wirapati P, et al. (2008) Biological processes associated with breast cancer clinical outcome depend on the molecular subtypes. Clin Cancer Res 14: 5158–65

    Article  CAS  PubMed  Google Scholar 

  4. Early Breast Cancer Trialists’ Collaborative Group (2011) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378: 771–84

    Article  Google Scholar 

  5. Fisher B, Dignam J, Bryant J, Wolmark N (2001) Five versus more than five years of tamoxifen for lymph node-negative breast cancer: updated findings from the National Surgical Adjuvant Breast and Bowel Project B-14 randomized trial. J Natl Cancer Inst 93: 684–90

    Article  CAS  PubMed  Google Scholar 

  6. Davies C, Pan H, Godwin J, et al. (2013) 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. Lancet 381: 805–16

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Gray RG, Rea D, Handley K, et al. (2013) aTTom: Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer. ASCO, Chicago, US. J Clin Oncol 31 (suppl; abstr 5)

  8. Al-Mubarak M, Tibau A, Templeton AJ, et al. (2014) Extended adjuvant tamoxifen for early breast cancer: a meta-analysis. PLoS One 9: e88238

    Article  PubMed  PubMed Central  Google Scholar 

  9. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2015) Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet 386: 1341–52. doi: 10.1016/S0140-6736(15)61074-1. Epub 2015 Jul 23

    Article  Google Scholar 

  10. Goss PE, Ingle JN, Martino S, et al. (2003) A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med 349: 1793–802

    Article  CAS  PubMed  Google Scholar 

  11. Goss PE, Ingle JN, Martino S, et al. (2005) Randomized trial of letrozole following tamoxifen as extended adjuvant therapy in receptor-positive breast cancer: updated findings from NCIC CTG MA.17. J Natl Cancer Inst 97: 1262–71

    Article  CAS  PubMed  Google Scholar 

  12. Pagani O, Regan MM, Walley BA, et al. (2014) Adjuvant exemestane with ovarian suppression in premenopausal breast cancer. N Engl J Med 371: 107–18

    Article  PubMed  PubMed Central  Google Scholar 

  13. Francis PA, Regan MM, Fleming GF, et al. (2015) Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med 372: 436–46

    Article  PubMed  Google Scholar 

  14. Dubsky P, Brase JC, Jakesz R, et al. (2013) The EndoPredict score provides prognostic information on late distant metastases in ER+/HER2–breast cancer patients. Br J Cancer 109: 2959–64

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Sestak I, Cuzick J, Dowsett M, et al. (2015) Prediction of late distant recurrence after 5 years of endocrine treatment: a combined analysis of patients from the Austrian breast and colorectal cancer study group 8 and arimidex, tamoxifen alone or in combination randomized trials using the PAM50 risk of recurrence score. J Clin Oncol 33: 916–22

    Article  CAS  PubMed  Google Scholar 

  16. Baselga J, Campone M, Piccart M, et al. (2012) Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 366: 520–9

    Article  CAS  PubMed  Google Scholar 

  17. Tolaney SM, Barry WT, Dang CT, et al. (2015) Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer. N Engl J Med 372: 134–41

    Article  PubMed  PubMed Central  Google Scholar 

  18. Coates AS, Winer EP, Goldhirsch A, et al. (2015) Tailoring therapies-improving the management of early breast cancer: St Gallen International Expert Consensus on the primary therapy of early breast cancer 2015. Ann Oncol 26: 1533–46

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Piccart-Gebhart M, Holmes E, Baselga J, et al. (2016) Adjuvant Lapatinib and Trastuzumab for Early Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: Results From the Randomized Phase III Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization Trial. J Clin Oncol (in press)

    Google Scholar 

  20. Slamon DJ, Swain SM, Buyse M, et al. (2013) Primary results from BETH, a phase III controlled study of adjuvant chemotherapy and trastuzumab ± bevacizumab in patients with HER2-positive, node-positive or high-risk node-negative breast cancer. 36th Annual San Antonio Breast Cancer Symposium (SABCS). Abstract S1-03

    Google Scholar 

  21. Pogue-Geile KL, Song N, Jeong JH, et al. (2015) Intrinsic subtypes, PIK3CA mutation, and the degree of benefit from adjuvant trastuzumab in the NSABP-B31 trial. J Clin Oncol 33: 1340–7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Giuliano M, Hu H, Wang YC, et al. (2015) Upregulation of ER signaling as an adaptive mechanism of cell survival in HER2- positive breast tumors treated with anti-HER2 therapy. Clin Cancer Res 21: 3995–4003

    Article  CAS  PubMed  Google Scholar 

  23. Loi S, Michiels S, Salgado R, et al. (2014) Tumor infiltrating lymphocytes are prognostic in triple negative breast cancer and predictive for trastuzumab benefit in early breast cancer: results from the FinHER trial. Ann Oncol 25: 1544–50

    Article  CAS  PubMed  Google Scholar 

  24. Perez E, Anderson K, Romon EH, et al. (2014) Stromal tumorinfiltrating lymphocytes (S-TILs): in the alliance N9831 trial STILs are associated with chemotherapy benefit but not associated with trastuzumab benefit. San Antonio Breast Cancer Symposium. Abst S1.06

    Google Scholar 

  25. Sparano JA, Zhao F, Martino S, et al. (2015) Long-term followup of the E1199 phase III trial evaluating the role of taxane and schedule in operable breast cancer. J Clin Oncol 33: 2353–60

    Article  CAS  PubMed  Google Scholar 

  26. Citron ML, Berry DA, Cirrincione C, et al. (2003) Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol 21: 1431–9

    Article  CAS  PubMed  Google Scholar 

  27. Swain SM, Tang G, Geyer CE Jr, et al. (2013) Definitive results of a phase III adjuvant trial comparing three chemotherapy regimens in women with operable, node-positive breast cancer: the NSABP-B38 trial. J Clin Oncol 31: 3197–204

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Moebus V, Jackisch C, Lueck HJ, et al. (2010) Intense dosedense sequential chemotherapy with epirubicin, paclitaxel, and cyclophosphamide compared with conventionally scheduled chemotherapy in high-risk primary breast cancer: mature results of an AGO phase III study. J Clin Oncol 28: 2874–80

    Article  CAS  PubMed  Google Scholar 

  29. Del Mastro L, De Placido S, Bruzzi P, et al. (2015) Fluorouracil and dose-dense chemotherapy in adjuvant treatment of patients with early-stage breast cancer: an open-label, 2 × 2 factorial, randomised phase III trial. Lancet 385: 1863–72

    Article  PubMed  Google Scholar 

  30. Gonzalez-Angulo AM, Timms KM, Liu S, et al. (2011) Incidence and outcome of BRCA mutations in unselected patients with triple receptor-negative breast cancer. Clin Cancer Res 17: 1082–9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Polley MY, Leung SC, McShane LM, et al. (2013) An international Ki67 reproducibility study. J Natl Cancer Inst 105: 1897–906

    Article  PubMed  PubMed Central  Google Scholar 

  32. Cobain EF, Hayes DF (2015) Indications for prognostic gene expression profiling in early breast cancer. Curr Treat Options Oncol 16: 23

    Article  PubMed  Google Scholar 

  33. Paik S, Tang G, Shak S, et al. (2006) Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol 24: 3726–34

    Article  CAS  PubMed  Google Scholar 

  34. Albain KS, Barlow WE, Shak S, et al. (2010) Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol 11: 55–65

    Article  CAS  PubMed  Google Scholar 

  35. Sparano JA, Gray RJ, Makower DF, et al. (2015) Prospective validation of a 21-gene expression assay in breast cancer. N Engl J Med 373: 2005–14

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Paik S, Shak S, Tang G, et al. (2004) A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med 351: 2817–26

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to S. Guiu or F. Dalenc.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guiu, S., Dalenc, F. Les traitements adjuvants des cancers du sein : dernières avancées et perspectives pour des cancers très différents. Oncologie 18, 120–127 (2016). https://doi.org/10.1007/s10269-016-2591-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10269-016-2591-y

Mots clés

Keywords

Navigation