Breakthrough in refractory breast cancer: Beat chemotherapy

A major breakthrough in refractory breast cancer! 4 advantages of “beat chemotherapy”

A major breakthrough in refractory breast cancer! Beat chemotherapy. In the early stage of breast cancer, surgical removal of the tumor is generally recommended, but for patients with advanced and unresectable, if symptomatic treatment is required, it can be further subdivided into:

• luminal cell type (hormone-positive type)
• HER2-positive type
• three Negative breast cancer.

01 The incidence of triple negative breast cancer

Triple-negative breast cancer is named because estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor (HER2) are all negative.

The prognosis of triple-negative breast cancer is worse than that of hormonal breast cancer, whether it is early or late. Especially in the past, only surgery and chemotherapy were used, and the survival rate was almost directly halved.

Triple-negative breast cancer has the characteristics of rapid deterioration, rapid metastasis, high mortality and high recurrence.

It usually occurs in 35-year-old young women. Singles who have not given birth and preference for meat may be risk factors. Clinically, the incidence of triple-negative breast cancer accounts for about 10% to 15% of breast cancer patients, and hereditary breast cancers with BRCA1/BRCA2 gene mutations account for about 5% of all breast cancer patients.

Because the early treatment effect of triple-negative breast cancer is better, it is recommended that 40-year-old female friends should be screened for breast cancer; if people have hereditary breast cancer, they can be confirmed by blood test for BRCA gene, and screening should be carried out before the age of 35. Check.

The symptoms of triple-negative breast cancer are the same as those of general breast cancer. It may start from the discovery of breast lumps; but what is more special is that triple-negative breast cancer lumps grow much faster than general breast cancer.

Some doctors say that if a small tumor of 1 cm is found in the chest, triple-negative breast cancer may grow to more than 2 to 3 cm, or even more than 5 cm in 2 to 3 months, and may start to have pain; but general breast cancer may last for half a year There is no change, and because the metastasis of triple-negative breast cancer is different from the hormonal type, there may be other discomforts.

Generally, breast cancer is easier to metastasize to the bones, and there will be bone pain, but triple-negative breast cancer is easy to metastasize to the internal organs and brain, such as the liver and lungs, and symptoms such as dry cough, wheezing, or headache may occur.

02 Treatment of triple negative breast cancer

Because triple-negative breast cancer tests are all negative, hormone therapy or targeted drugs cannot be used. In the past, chemotherapy was only available.

Chemotherapy

Chemotherapy has long been the most important method of treating many types of cancer. How to increase the efficacy of chemotherapy has always been the focus of medical attention.

The efficacy of chemotherapy has been constantly revised with the findings of basic research. From the traditional once every 3 to 4 weeks (the so-called maximum tolerable dose strategy), it has evolved into a high-dose, multiple and intensive chemotherapy combined with leukogen Or stem cell support, and then evolved into what is now called rhythm chemotherapy.

Recently, the breast cancer team of Sun Yat-sen University Cancer Center has made new progress in the treatment of early triple-negative breast cancer, and found that the use of the chemotherapy drug capecitabine for maintenance treatment in the “beat chemotherapy” mode can significantly improve early triple-negative breast cancer The patient’s 5-year disease-free survival rate. Related research has been published in the top international medical journal “Journal of the American Medical Association” (JAMA).

Beat chemotherapy

Cycle chemotherapy is a concept proposed by the scholar Kerbel of the University of Toronto in Canada. It refers to the use of low-dose chemotherapy drugs, which is equivalent to 1/10 to 1/3 of the conventional dose, uninterrupted, continuous or high frequency (1 to 3 times a week) Administration, a chemotherapy model that uses activated endothelial cells in the tumor as the therapeutic target.

Due to the frequent administration of rhythm chemotherapy, the target is mainly activated vascular endothelial cells in the tumor, rather than tumor cells.

Due to the reduced dosage, the rhythm chemotherapy has the advantages of low chemotherapy side effects, low drug resistance, convenient long-term administration, and low treatment cost.

Oral chemotherapy drugs are more suitable for rhythm chemotherapy because of their convenience. Among them, the representative drugs are:

• Vinorelbine,
• Methotrexate
• Cyclophosphamide,
• S-1,
• Capecitabine

Capecitabine is a chemotherapeutic drug that has been used clinically for many years. Through low-dose, high-frequency continuous oral “beat chemotherapy” new medication mode, it has good effectiveness and safety in the treatment of advanced tumors.

03 “Beat Chemotherapy” for triple-negative breast cancer

Inspired by this, breast cancer experts such as Yuan Zhongyu, Wang Xi, and Wang Shusen from the Cancer Center of Sun Yat-sen University led a team to focus on early triple-negative breast cancer and conduct research on the effect of capecitabine “beat chemotherapy” as a maintenance treatment. This research started in 2010 and was successfully completed this year through the joint efforts of 13 Chinese cooperative units.

The results of this study show that patients who continue to use capecitabine for maintenance therapy with low-dose, high-frequency “beat chemotherapy” after the end of standard treatment can reduce the risk of early triple-negative breast cancer recurrence by more than 1/3 , Which improves the 5-year disease-free survival rate of patients from 73.0% to 82.8%.

Yuan Zhongyu, chief physician of the Department of Internal Medicine, Sun Yat-sen University Cancer Center, said that “beat chemotherapy” is safe, and 83% of patients can successfully complete the entire treatment without serious side effects. “In addition, the total cost of maintenance treatment with Chinese-made capecitabine for one year is less than 4,000 yuan (about US$611). After reimbursement by Chinese citizen’s medical insurance, patients only need to bear about 1,000 yuan (about US$153). Cost-effective and universal.”

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