臨床外科66巻11号

2011年10月発行

特集 外科医のための最新癌薬物療法 Ⅰ章 臓器別薬物療法

1．乳癌―②術後補助療法

著者： 柏葉匡寛¹ 稲葉亨¹ 小松英明¹ 川岸涼子¹ 松井雄介¹ 若林剛¹

所属機関： ¹岩手医科大学外科学講座

ページ範囲：P.18 - P.36

術後補助療法の適応とレジメン選択

　乳癌の術後補助療法は，原発巣切除後にも存在している微小転移を標的とした全身的薬物療法であり，原発巣における治療標的分子の発現が効果予測因子である．また，乳癌の特徴としてホルモン療法を含む特定分子の存在下に有効な分子標的療法と，細胞増殖にかかわる様々な段階を標的分子の有無にかかわらず抑制する化学療法によって構成されている．本稿では，ほかの疾患との整合性を考慮し，非浸潤癌に対するホルモン療法を割愛している．

参考文献

1）Kurosumi M：Immunohistochemical assessment of hormone receptor status using a new scoring system（J-Score）in breast cancer. Breast Cancer 14：189-193, 2007

2）Goldhirsh A, et al：“Thresholds for therapies：highlights of the St. Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol 20：1319-1329, 2009

3）Allred DC, et al：Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol 11：155-168, 1999

4）National Comprehensive Cancer Network（NCCN）guidelines. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

5）Cuzick J, et al：Use of luteinising-hormone-releasing hormone agonists as adjuvant treatment in premenopausal patients with hormone-receptor-positive breast cancer：a meta-analysis of individual patient data from randomised adjuvant trials. Lancet 369：1711-1723, 2007

6）Sverrisdottir A, et al：Interaction between Goserelin and Tamoxifen in a Controlled Clinical Trial of Adjuvant Endocrine Therapy in Premenopausal Breast Cancer. SABCS, S1-5, 2010

7）Gnant M, et al：Adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer：62-month follow-up from the ABCSG-12 randomised trial. Lancet Oncol 12：631-641, 2011

St. Gallen International Breast Cancer Conference. http://www.oncoconferences.ch/dynasite.cfm?dsmid＝108654

9）Arimidex, Tamoxifen, Alone or in Combination（ATAC）Trialists' Group, Forbes JF, et al：Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer：100-month analysis of the ATAC trial. Lancet Oncol 9：45-53, 2008

10）Breast International Group（BIG）1-98 Collaborative Group, Thürlimann B, et al：A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med 353：2747-2757, 2005

11）van de Velde CJ, et al：Adjuvant tamoxifen and exemestane in early breast cancer（TEAM）：a randomised phase 3 trial. Lancet 377：321-331, 2011

12）Mouridsen HT, et al：BIG 1-98：A randomized double-blind phase Ⅲ study evaluating letrozole and tamoxifen given in sequence as adjuvant endocrine therapy for postmenopausal women with receptor-positive breast cancer. SABCS, 2008 #13

13）Coombes RC, et al：Survival and safety of exemestane versus tamoxifen after 2-3 years' tamoxifen treatment（Intergroup Exemestane Study）：a randomised controlled trial. Lancet 369：559-570, 2007

14）Goss PE, et al：A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med 349：1793-1802, 2003

15）Early Breast Cancer Trialists' Collaborative Group（EBCTCG）, Clarke M, et al：Adjuvant chemotherapy in oestrogen-receptor-poor breast cancer：patient-level meta-analysis of randomised trials. Lancet 371：29-40, 2008

16）Woods KE, Randolph JK, Gewirtz DA：Antagonism between tamoxifen and doxorubicin in the MCF-7 human breast tumor cell line. Biochem Pharmacol 47：1449-1452, 1994

17）Albain KS, et al：Breast Cancer Intergroup of North America：Adjuvant chemotherapy and timing of tamoxifen in postmenopausal patients with endocrine-responsive, node-positive breast cancer：a phase 3, open-label, randomised controlled trial. Lancet 374：2055-2063, 2009

18）Jin Y, et al：CYP2D6 genotype, antidepressant use, and tamoxifen metabolism during adjuvant breast cancer treatment. J Natl Cancer Inst 97：30-39, 2005

19）Perou CM, et al：Molecular portraits of human breast tumours. Nature 406：747-752, 2000

20）Henderson IC, et al：Improved outcomes from adding sequential Paclitaxel but not from escalating Doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol 21：976-983, 2003

21）Muss HB, et al：Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med 360：2055-2065, 2009

22）Jones S, et al：Docetaxel with cyclophosphamide is associated with an overall survival benefit compared with doxorubicin and cyclophosphamide：7-year follow-up of US Oncology Research Trial 9735. J Clin Oncol 27：1177-1183, 2009

23）Jones SE, et al：Phase Ⅲ trial comparing doxorubicin plus cyclophosphamide with docetaxel plus cyclophosphamide as adjuvant therapy for operable breast cancer. J Clin Oncol 24：5381-5387, 2006

24）Sparano JA, et al：Weekly paclitaxel in the adjuvant treatment of breast cancer. N Engl J Med 358：1663-1671, 2008

25）Pinder MC, et al：Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer. J Clin Oncol 25：3808-3815, 2007

26）Tancini G, et al：Adjuvant CMF in breast cancer：comparative 5-year results of 12 versus 6 cycles. J Clin Oncol 1：2-10, 1983

27）Jones SE, et al：Adjuvant chemotherapy with doxorubicin and cyclophosphamide in women with rapidly proliferating node-negative breast cancer. Clin Breast Cancer 3：147-152, 2002

28）French Adjuvant Study Group：Benefit of a high-dose epirubicin regimen in adjuvant chemotherapy for node-positive breast cancer patients with poor prognostic factors：5-year follow-up results of French Adjuvant Study Group 05 randomized trial. J Clin Oncol 19：602-611, 2001

29）Martin M, et al：Doxorubicin in combination with fluorouracil and cyclophosphamide（i. v. FAC regimen, day 1, 21）versus methotrexate in combination with fluorouracil and cyclophosphamide（i. v. CMF regimen, day 1, 21）as adjuvant chemotherapy for operable breast cancer：a study by the GEICAM group. Ann Oncol 14：833-842, 2003

30）Toi M, et al：Phase Ⅱ study of preoperative sequential FEC and docetaxel predicts of pathological response and disease free survival. Breast Cancer Res Treat 110：531-539, 2008

31）Wolff AC, et al：American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol 25：118-145, 2007

32）Piccart-Gebhart MJ, et al：Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 353：1659-1672, 2005

33）Romond EH, et al：Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 353：1673-1684, 2005

34）Slamon D, et al：Phase Ⅲ Randomized Trial Comparing Doxorubicin and Cyclophosphamide Followed by Docetaxel（AC→T）with Doxorubicin and Cyclophosphamide Followed by Docetaxel and Trastuzumab（AC→TH）with Docetaxel, Carboplatin and Trastuzumab（TCH）in Her2 neu Positive Early Breast Cancer Patients：BCIRG 006 Study. SABCS, 2009 #62

35）Sawaki M, et al：Evaluation of trastuzumab without chemotherapy as a post-operative adjuvant therapy in HER2-positive elderly breast cancer patients：randomized controlled trial［RESPECT（N-SAS BC07）］. Jpn J Clin Oncol 41：709-712, 2011