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SABCS15:为何他莫昔芬对部分激素敏感性乳腺癌患者无效

2015-12-11 QQduhq 译 MedSci原创

圣安东尼奥乳腺癌研讨会提出的2项研究的观点认为,他莫西芬具有降低雌激素功能的作用,因此可以使激素敏感性乳腺癌患者复发的风险减半,但是仅对部分患者有效。 安阿伯市密歇根大学的Daniel L. Hertz参与了这两项研究。他认为,他莫西芬不能避免一些乳腺癌患者肿瘤复发的原因是肿瘤发现了抵抗雌激素拮抗剂治疗方案的方法,此外,有些患者治疗效果不好是因为基因如此。 他莫西芬需要完全代谢成endoxifen

圣安东尼奥乳腺癌研讨会提出的2项研究的观点认为,他莫西芬具有降低雌激素功能的作用,因此可以使激素敏感性乳腺癌患者复发的风险减半,但是仅对部分患者有效。


安阿伯市密歇根大学的Daniel L. Hertz参与了这两项研究。他认为,他莫西芬不能避免一些乳腺癌患者肿瘤复发的原因是肿瘤发现了抵抗雌激素拮抗剂治疗方案的方法,此外,有些患者治疗效果不好是因为基因如此。 

他莫西芬需要完全代谢成endoxifen形式,治疗效果才更好。他莫西芬在一些病人体内无效是因为,在这些患者中,他莫昔芬分解产生的endoxifen较少。

一些研究表明,含有CYP2D6基因的乳腺癌患者采用他莫西芬药物治疗效果不好。Hertz博士和同事对此进行了再次分析,以研究CYP2D6基因变异是否会导致他莫昔芬效果有影响及其差异。

在先进的统计工具的帮助下, Hertz 教授和他的同事们的研究表明,既往前瞻性实验针对基因分型错误的偏差可以忽略不计。

针对为何他莫西芬对一些肿瘤患者有效而对其他患者无效,研究人员认为,还是要从基因出发进行分析。

在第二项研究中,教授和他的同事们发现,激活他莫西芬分解为endoxifen这一过程似乎与CYP2D6变异无关,而是与CYP2C9基因有关。

教授指出,影响他莫西芬效果应与基因有关,但是仍然需要更近一步的研究去探究所有的假设与猜想。

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    2015-12-26 hixiaoluo

    好文章,值得看。

    0

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