Oncologie

, Volume 10, Issue 2, pp 136–148 | Cite as

Cancer du sein métastatique

Prise en charge différentielle en fonction des caractéristiques clinicopathologiques: réflexions d’experts sur les facteurs pronostiques, prédictifs d’efficacité et de décision thérapeutique
  • Mario Campone
  • Gaël Deplanque
  • Nadine Dohollou
  • Joseph Gligorov
  • Rémy Largillier
  • Moïse Namer
  • Frédérique Penault-Llorca
  • Thierry Petit
  • Marc Spielmann
  • Laurent Zelek
Oncologie
  • 70 Downloads

Résumé

Si la prise en charge du cancer du sein précoce est relativement bien codifiée, il n’en est pas de même pour le cancer du sein métastatique où les attitudes sont extrêmement variables. Les recommandations édictées pour la prise en charge du cancer du sein métastatique visent essentiellement à établir une liste des molécules disponibles et des traitements possibles en fonction du statut ménopausique et des récepteurs hormonaux (RH). Si l’on considère tous les éléments pouvant influencer la décision thérapeutique, l’objectif de la présente réflexion a été de s’orienter vers une attitude consensuelle chez les patientes ayant un cancer du sein métastatique. Les facteurs pronostiques décisionnels retenus ont été l’intervalle libre sans maladie, la localisation viscérale des métastases, les RH et éventuellement les LDH. Les facteurs prédictifs acquis de la réponse au traitement sont les RH et le statut HER2. Le choix de ces facteurs prédictifs et l’agressivité de la maladie ont conditionné les options thérapeutiques de première ligne à savoir chimiothérapie (mono-ou polychimiothérapie, concomitante ou séquentielle), hormonothérapie ou hormonochimiothérapie.

Mots clés

Cancer du sein métastatique Facteurs pronostiques Facteurs prédictifs Chimiothérapie Hormonothérapie 

Metastatic breast cancers

Abstract

Although the treatment of early breast cancer is relatively well-defined, therapeutic options for metastatic breast cancer remains controversial. The published guidelines for the management of metastatic breast cancer mainly aim to draw up a list of available agents and treatments according to menopausal status and hormone receptors (HR). Taking into account all the variables influencing therapeutic decision-making, the purpose of the present study was to find a consensus with respect to patients with metastatic breast cancer. The selected prognostic factors were disease-free duration, visceral metastasis, HR, and possibly LDH. The validated predictive factors of response to treatment were HR and HER2 status. The choice of these predictive factors as well as the disease’s level of aggressiveness were the basis for the choice of first-line treatment i.e. chemotherapy (mono-or polychemotherapy, concomitant or sequential), hormonotherapy, or chemoendocrine therapy.

Keywords

Metastatic breast cancer Prognostic factors Predictive factors Chemotherapy Hormonotherapy 

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Copyright information

© Springer Verlag France 2008

Authors and Affiliations

  • Mario Campone
    • 1
  • Gaël Deplanque
    • 2
  • Nadine Dohollou
    • 3
  • Joseph Gligorov
    • 4
  • Rémy Largillier
    • 5
  • Moïse Namer
    • 6
  • Frédérique Penault-Llorca
    • 7
  • Thierry Petit
    • 8
  • Marc Spielmann
    • 9
  • Laurent Zelek
    • 10
  1. 1.centre René-GauducheauNantes Saint-HerblainFrance
  2. 2.Fondation hôpital Saint-JosephParisFrance
  3. 3.polyclinique de Bordeaux-NordBordeauxFrance
  4. 4.hôpital TenonParisFrance
  5. 5.centre Antoine-LacassagneNiceFrance
  6. 6.clinique médicaleMouginsFrance
  7. 7.centre Jean-PerrinClermont-FerrandFrance
  8. 8.centre Paul-StraussStrasbourgFrance
  9. 9.institut Gustave-RoussyVillejuifFrance
  10. 10.CHU AvicenneBobignyFrance

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