Onkológia 6/2018
Principles of hormonal therapy and chemotherapy in the treatment of metastatic HR+, HER2- breast cancer
Approximately third of patients with breast cancer is treated for metastatic disease. Initial endocrine therapy is the treatment of choice for hormone-positive tumour except when disease is manifested by a visceral crisis or is progressing rapidly. Endocrine treatment is highly effective and less toxic compared to chemotherapy. Emergence of hormonal resistance is major cause shortening the chemotherapy-free period. Possibilities to overcome hormonal resistance comprise combination of endocrine therapy (tamoxifen, fulvestrant, aromatase inhibitors) with CKD4/6 inhibitors or mTOR and PI3K inhibitors. Optimal sequence of endocrine therapy still remains an unanswered question along with the definition of markers allowing the selection of patients who will benefit most from both the endocrine monotherapy and combined therapy.
Keywords: breast cancer, hormonal treatment, inhibitors CDK 4/6, palbociclib, ribociclib, abemaciklib, everolimus, chemotherapy
