Selecting Breast Cancer Patients for Chemotherapy: The Opening of the UK OPTIMA Trial

被引:34
作者
Bartlett, J. [1 ]
Canney, P. [2 ]
Campbell, A. [3 ]
Cameron, D. [4 ,5 ]
Donovan, J. [6 ]
Dunn, J. [3 ]
Earl, H. [7 ]
Francis, A. [8 ]
Hall, P. [9 ]
Harmer, V. [10 ]
Higgins, H. [3 ]
Hillier, L. [3 ]
Hulme, C. [9 ]
Hughes-Davies, L. [7 ]
Makris, A. [11 ]
Morgan, A. [12 ]
McCabe, C. [13 ]
Pinder, S. [14 ]
Poole, C. [15 ]
Rea, D. [16 ]
Stallard, N. [17 ]
Stein, R. [18 ,19 ]
机构
[1] Ontario Inst Canc Res, Toronto, ON, Canada
[2] Beatson W Scotland Canc Ctr, Dept Oncol, Glasgow, Lanark, Scotland
[3] Univ Warwick, Warwick Med Sch, Warwick Clin Trials Unit, Coventry CV4 7AL, W Midlands, England
[4] Univ Edinburgh, Dept Med Oncol, Edinburgh, Midlothian, Scotland
[5] NHS Lothian, Edinburgh, Midlothian, Scotland
[6] Univ Bristol, Sch Social & Community Med, Bristol, Avon, England
[7] Addenbrookes Hosp, Dept Oncol, Cambridge, England
[8] Queen Elizabeth Hosp, Univ Hosp Birmingham, Dept Breast Surg Oncol, Birmingham B15 2TH, W Midlands, England
[9] Univ Leeds, Leeds Inst Hlth Sci, Acad Unit Hlth Econ, Leeds, W Yorkshire, England
[10] St Marys Hosp, London, England
[11] Mt Vernon Hosp, Dept Clin Oncol, Northwood HA6 2RN, Middx, England
[12] Independent Canc Patients Voice, London, England
[13] Dept Emergency Med Res, Edmonton, AB, Canada
[14] Kings Coll London, Div Canc Studies, Guys Hosp, London WC2R 2LS, England
[15] Univ Hosp Coventry & Warwickshire, Arden Canc Ctr, Coventry, W Midlands, England
[16] Univ Birmingham, Sch Canc Sci, Birmingham, W Midlands, England
[17] Univ Warwick, Warwick Med Sch, Coventry, W Midlands, England
[18] UCL Hosp, Dept Oncol, London NW1 2PG, England
[19] UCLH UCL NIHR Biomed Res Ctr, London, England
关键词
Adjuvant; breast; chemotherapy; predictive; ONCOLOGY; 2007; UPDATE; RECURRENCE SCORE ASSAY; ESTROGEN-RECEPTOR; AMERICAN SOCIETY; TUMOR-MARKERS; ADJUVANT ANTHRACYCLINE; DECISION-MAKING; GENE-EXPRESSION; WOMEN; RISK;
D O I
10.1016/j.clon.2012.10.005
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The mortality from breast cancer has improved steadily over the past two decades, in part because of the increased use of more effective adjuvant therapies. Thousands of women are routinely treated with intensive chemotherapy, which can be unpleasant, is expensive and is occasionally hazardous. Oncologists have long known that some of these women may not need treatment, either because they have a low risk of relapse or because they have tumour biology that makes them less sensitive to chemotherapy and more suitable for early adjuvant endocrine therapy. There is an urgent need to improve patient selection so that chemotherapy is restricted to those patients who will benefit from it. Here we review the emerging technologies that are available for improving patient selection for chemotherapy. We describe the OPTIMA trial, which has just opened to recruitment in the UK, is the latest addition to trials in this area, and is the first to focus on the relative cost-effectiveness of alternate predictive assays. (c) 2012 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.
引用
收藏
页码:109 / 116
页数:8
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