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Фулвестрант – эндокринная терапия расширенного спектра действия
Фулвестрант – эндокринная терапия расширенного спектра действия
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Аннотация
Фулвестрант представляет собой новый класс лекарственных препаратов для эндокринной терапии рака молочной железы. Уникальный механизм действия – деградация рецепторов эстрогенов – позволяет не только применять препарат в качестве монотерапии гормонозависимого рака молочной железы, но и создавать необычные комбинации противоопухолевых препаратов с его включением. Изучение фулвестранта активно продолжается. В последнее время опубликована целая серия интересных данных по лечению диссеминированного гормонозависимого рака молочной железы. Особый интерес представляет комбинация фулвестранта и анастрозола, опровергающая существующую тактику последовательного применения препаратов для эндокринной терапии рака молочной железы. Не меньше интригуют экспериментальные данные о возможном применении препарата в комбинации с цитостатиками, а также о применении его при других злокачественных опухолях, где никогда ранее эндокринная терапия не применялась. В статье будут представлены последние данные, касающиеся препарата фулвестрант, в том числе алгоритм его применения и перспективные направления развития.
Ключевые слова: рак молочной железы, эндокринная терапия, фулвестрант, фазлодекс.
Investigations of fulvestrant are being actively continued. A large set of interesting data on the treatment of disseminated hormone-dependent breast cancer has been recently published. The fulvestrant-and-anastrozole combination that dispels the existing tactics in the successive use of medications for endocrine therapy of breast cancer is of specific interest. But no less intriguing is experimental evidence that the drug may be used in combination with cytostatics and in other malignant tumors for which endocrine therapy has never been used. The paper gives the latest data on fulvestrant, including its use algorithm and promising development directions.
Key words: breast cancer, endocrine therapy, fulvestrant, faslodex.
Ключевые слова: рак молочной железы, эндокринная терапия, фулвестрант, фазлодекс.
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Investigations of fulvestrant are being actively continued. A large set of interesting data on the treatment of disseminated hormone-dependent breast cancer has been recently published. The fulvestrant-and-anastrozole combination that dispels the existing tactics in the successive use of medications for endocrine therapy of breast cancer is of specific interest. But no less intriguing is experimental evidence that the drug may be used in combination with cytostatics and in other malignant tumors for which endocrine therapy has never been used. The paper gives the latest data on fulvestrant, including its use algorithm and promising development directions.
Key words: breast cancer, endocrine therapy, fulvestrant, faslodex.
Полный текст
Список литературы
1. Huang HJ, Neven P, Drijkoningen M et al. Association between tumour characteristics and HER-2/neuby immunohistochemistry in 1362 women with primary operable breast cancer. J Clin Pathol 2005; 58: 611–6.
2. Wakeling AE, Dukes M, Bowler J. A potent specific pure antiestrogen with clinical potential. Cancer Res 1991; 51: 3867–73.
3. Krell J, Januszewski A, Yan K et al. Role of fulvestrant in the management of postmenopausal breast cancer. Expert Rev Anticancer Ther 2011; 11 (11): 1641–52.
4. Di Leo A, Jerusalem G, Petruzelka LJ et al. Results of the CONFIRM phase III trial comparing fulvestrant 250 mg with fulvestrant 500 mg in postmenopausal women with estrogen receptor-positive advanced breast cancer. J Clin Oncol 2010; 28 (30): 4594–600.
5. Ohno S, Rai Y, Iwata H et al. Three dose regimens of fulvestrant in postmenopausal Japanese women with advanced breast cancer: results fr om a double-blind, phase II comparative study (FINDER1). Ann Oncol 2010; 21 (12): 2342–7.
6. Pritchard KI, Rolski J, Papai Z. Results of a phase II study comparing three dosing regimens of fulvestrant in postmenopausal women with advanced breast cancer (FINDER2). Breast Cancer Res Treat 2010; 123 (2): 453–61.
7. Kuter I, Gee JM, Hegg R et al. Dose-dependent change in biomarkers during neoadjuvant endocrine therapy with fulvestrant: results from NEWEST, a randomized Phase II study. Breast Cancer Res Treat 2012; 133 (1): 237–46.
8. Robertson JF, Llombart-Cussac A, Rolski J et al. Activity of fulvestrant 500 mg versus anastrozole 1 mg as first-line treatment for advanced breast cancer: results from the FIRST study. J Clin Oncol 2009; 27 (27): 4530–5.
9. A phase III randomized trial of anastrozole versus anastrozole and fulvestrant as first-line therapy for postmenopausal women with metastatic breast cancer, CTRC-AACR San Antonio Breast Cancer Symposium 2011.
10. Mehta RS, Barlow WE, Albain KS et al. Combination anastrozole and fulvestrant in metastatic breast cancer. N Engl J Med 2012; 367: 435–44.
11. Bergh J, Jönsson PE, Lidbrink EK et al. FACT: An Open-Label Randomized Phase III Study of Fulvestrant and Anastrozole in Combination Compared With Anastrozole Alone As First-Line Therapy for Patients With Receptor-Positive Postmenopausal Breast Cancer J Clin Oncol 2012; 30 (16): 1919–25.
12. Bartsch R, Bago-Horvath Z, Berghoff et al. Ovarian function suppression and fulvestrant as endocrine therapy in premenopausal women with metastatic breast cancer. Eur J Cancer 2012.
13. Robertson JF, Steger GG, Neven P et al. Activity of fulvestrant in HER2-overexpressing advanced breast cancer. Ann Oncol 2010; 21 (6): 1246–53.
14. Barrios C, Forbes JF, Jonat W et al. The sequential use of endocrine treatment for advanced breast cancer: wh ere are we? Ann Oncol 2012; 23: 1378–86.
15. Masci G, Gandini C, Zuradelli M et al. Fulvestrant for advanced male breast cancer patients: a case series. Ann Oncol 2011; 22: 985–93.
16. Ikeda H, Taira N, Nogami T et al. Combination treatment with fulvestrant and various cytotoxic agents (doxorubicin, paclitaxel, docetaxel, vinorelbine, and 5-fluorouracil) has a synergistic effect in estrogen receptor-positive breast cancer. Cancer Sci 2011; 102 (11): 2038–42.
17. Sui M, Jiang D, Hinsch C et al. Fulvestrant (ICI 182, 780) sensitizes breast cancer cells expressing estrogen receptor alpha to vinblastine and vinorelbine. Breast Cancer Res Treat 2010; 121 (2): 335–45.
18. Aurilio G, Munzone E, Botteri E et al. Oral Metronomic Cyclophosphamide and Methotrexate Plus Fulvestrant in Advanced Breast Cancer Patients: A Mono-Institutional Case-Cohort Report Breast J 2012; 10 (1111): 1524–41.
19. Xu R, Shen H, Guo R et al. Combine therapy of gefitinib and fulvestrant enhances antitumor effects on NSCLC cell lines with acquired resistance to gefitinib. Biomed Pharmacother 2012; 66 (5): 384–9.
20. Klinge CM. Inhibition of non-small-cell lung cancer growth by combined fulvestrant and vandetanib. Future Oncol 2012; 8 (5): 529–33.
21. Rajoria S, Suriano R, George AL et al. Molecular target based combinational therapeutic approaches in thyroid cancer. J Transl Med 2012; 10: 81.
2. Wakeling AE, Dukes M, Bowler J. A potent specific pure antiestrogen with clinical potential. Cancer Res 1991; 51: 3867–73.
3. Krell J, Januszewski A, Yan K et al. Role of fulvestrant in the management of postmenopausal breast cancer. Expert Rev Anticancer Ther 2011; 11 (11): 1641–52.
4. Di Leo A, Jerusalem G, Petruzelka LJ et al. Results of the CONFIRM phase III trial comparing fulvestrant 250 mg with fulvestrant 500 mg in postmenopausal women with estrogen receptor-positive advanced breast cancer. J Clin Oncol 2010; 28 (30): 4594–600.
5. Ohno S, Rai Y, Iwata H et al. Three dose regimens of fulvestrant in postmenopausal Japanese women with advanced breast cancer: results fr om a double-blind, phase II comparative study (FINDER1). Ann Oncol 2010; 21 (12): 2342–7.
6. Pritchard KI, Rolski J, Papai Z. Results of a phase II study comparing three dosing regimens of fulvestrant in postmenopausal women with advanced breast cancer (FINDER2). Breast Cancer Res Treat 2010; 123 (2): 453–61.
7. Kuter I, Gee JM, Hegg R et al. Dose-dependent change in biomarkers during neoadjuvant endocrine therapy with fulvestrant: results from NEWEST, a randomized Phase II study. Breast Cancer Res Treat 2012; 133 (1): 237–46.
8. Robertson JF, Llombart-Cussac A, Rolski J et al. Activity of fulvestrant 500 mg versus anastrozole 1 mg as first-line treatment for advanced breast cancer: results from the FIRST study. J Clin Oncol 2009; 27 (27): 4530–5.
9. A phase III randomized trial of anastrozole versus anastrozole and fulvestrant as first-line therapy for postmenopausal women with metastatic breast cancer, CTRC-AACR San Antonio Breast Cancer Symposium 2011.
10. Mehta RS, Barlow WE, Albain KS et al. Combination anastrozole and fulvestrant in metastatic breast cancer. N Engl J Med 2012; 367: 435–44.
11. Bergh J, Jönsson PE, Lidbrink EK et al. FACT: An Open-Label Randomized Phase III Study of Fulvestrant and Anastrozole in Combination Compared With Anastrozole Alone As First-Line Therapy for Patients With Receptor-Positive Postmenopausal Breast Cancer J Clin Oncol 2012; 30 (16): 1919–25.
12. Bartsch R, Bago-Horvath Z, Berghoff et al. Ovarian function suppression and fulvestrant as endocrine therapy in premenopausal women with metastatic breast cancer. Eur J Cancer 2012.
13. Robertson JF, Steger GG, Neven P et al. Activity of fulvestrant in HER2-overexpressing advanced breast cancer. Ann Oncol 2010; 21 (6): 1246–53.
14. Barrios C, Forbes JF, Jonat W et al. The sequential use of endocrine treatment for advanced breast cancer: wh ere are we? Ann Oncol 2012; 23: 1378–86.
15. Masci G, Gandini C, Zuradelli M et al. Fulvestrant for advanced male breast cancer patients: a case series. Ann Oncol 2011; 22: 985–93.
16. Ikeda H, Taira N, Nogami T et al. Combination treatment with fulvestrant and various cytotoxic agents (doxorubicin, paclitaxel, docetaxel, vinorelbine, and 5-fluorouracil) has a synergistic effect in estrogen receptor-positive breast cancer. Cancer Sci 2011; 102 (11): 2038–42.
17. Sui M, Jiang D, Hinsch C et al. Fulvestrant (ICI 182, 780) sensitizes breast cancer cells expressing estrogen receptor alpha to vinblastine and vinorelbine. Breast Cancer Res Treat 2010; 121 (2): 335–45.
18. Aurilio G, Munzone E, Botteri E et al. Oral Metronomic Cyclophosphamide and Methotrexate Plus Fulvestrant in Advanced Breast Cancer Patients: A Mono-Institutional Case-Cohort Report Breast J 2012; 10 (1111): 1524–41.
19. Xu R, Shen H, Guo R et al. Combine therapy of gefitinib and fulvestrant enhances antitumor effects on NSCLC cell lines with acquired resistance to gefitinib. Biomed Pharmacother 2012; 66 (5): 384–9.
20. Klinge CM. Inhibition of non-small-cell lung cancer growth by combined fulvestrant and vandetanib. Future Oncol 2012; 8 (5): 529–33.
21. Rajoria S, Suriano R, George AL et al. Molecular target based combinational therapeutic approaches in thyroid cancer. J Transl Med 2012; 10: 81.
Авторы
А.А.Мещеряков
ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН, Москва
ФГБУ Российский онкологический научный центр им. Н.Н.Блохина РАМН, Москва
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