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Acquis et limites de l’hormonothérapie adjuvante

Endocrine treatment in breast cancer in adjuvant setting: a lot done, still a lot to be done

  • Conference paper
Acquis et limites en sénologie / Assets and limits in breast diseases

  • 227 Accesses

Résumé

Depuis plus de 25 ans, les méta-analyses de l’EBCTCG se suivent et se ressemblent concernant le tamoxifène (TAM) : son administration durant 5 ans réduit le risque relatif de rechute de 47 % ± 3 % durant les 5 premières années et de 32 % ± 6 % durant les années suivantes. Au-delà de la 10e année, ce bénéfice se maintient montrant que l’hormonothérapie (HT) ne fait pas que retarder les rechutes, mais a un rôle curatif. La mortalité annuelle par cancer du sein est réduite d’environ un tiers (RR = 0,70 ± 0,05) durant les 15 premières années. Ce bénéfice est indépendant de l’age, des différents facteurs pronostiques, ou encore de l’administration d’une chimiothérapie [1]. Se basant sur une autre méta-analyse ayant porté sur 19 000 patientes [2], toutes les sociétés savantes recommandent aujourd’hui d’intégrer un inhibiteur de l’aromatase (IA) chez les patientes ménopausées : l’administration d’un IA permet une réduction supplémentaire du risque relatif de rechute de 23%± 5 % (si administré d’emblée) à 29 % ± 6 % (en relai après 2–3 ans de TAM) par rapport au TAM seul, soit un bénéfice absolu de 3 % à 5 ans dans ces études où 40 % des patientes environ présentaient une atteinte ganglionnaire (N+).

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    Article  PubMed  CAS  Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

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    Article  PubMed  Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

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    PubMed  CAS  Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

  42. Bachelot T, Bourgier C, Cropet C et al. (2012) Randomized Phase II Trial of Everolimus in Combination With Tamoxifen in Patients With Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer With Prior Exposure to Aromatase Inhibitors: A GINECO Study. J Clin Oncol 30: 2718–2724

    Article  PubMed  CAS  Google Scholar 

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    Article  PubMed  Google Scholar 

  44. Oberguggenberger A, Hubalek M, Sztankay M et al. (2011) Is the toxicity of adjuvant aromatase inhibitor therapy underestimated? Complementary information from patient-reported outcomes (PROs). Breast Cancer Res Treat 128: 553–561

    Article  PubMed  CAS  Google Scholar 

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  1. Département d’oncologie médicale, Institut Bergonié, 33000, Bordeaux, France

    M. Debled & L. Mauriac

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  2. L. Mauriac
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Debled, M., Mauriac, L. (2013). Acquis et limites de l’hormonothérapie adjuvante. In: Acquis et limites en sénologie / Assets and limits in breast diseases. Springer, Paris. https://doi.org/10.1007/978-2-8178-0396-8_12

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  • DOI: https://doi.org/10.1007/978-2-8178-0396-8_12

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0395-1

  • Online ISBN: 978-2-8178-0396-8

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