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Anti-HER-2 et hormonothérapies dans la prise en charge des cancers du sein: Indications

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Cancer du sein

Résumé

En cancérologie, le concept de » facteur prédictif thérapeutique « est issu de la connaissance d’une part de l’effet positif de l’hormonothérapie sur certains cancers du sein et d’autre part des récepteurs hormonaux (RH), (d’estradiol [RE] et de progestérone), présents dans environ 70 % des cancers du sein. On sait depuis 1896 qu’environ 35 % des cancers du sein sont améliorés par la castration avant la ménopause [1] et on sait depuis 1970 que seules les tumeurs RH+ sont hormono- sensibles et relèvent d’un traitement hormonal: pour ces tumeurs, tout se passe comme si la prolifération tumorale était sous la dépendance du RE activé par son ligand, l’estradiol, et que l’effet anti tumoral de l’hormonothérapie résultait précisément d’un blocage de cette cible. L’hormonothérapie adjuvante réduit de 31 % le risque de décès [2], alors qu’en première ligne métastatique environ 60 % des tumeurs RH(+) répondent à l’hormonothérapie et 40 % ne répondent pas (tableau I), ce qui laisse présumer qu’en adjuvant toutes les tumeurs RE(+) pourraient ne pas bénéficier de l’hormonothérapie.

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© 2012 Springer-Verlag France, Paris

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Guastalla, JP. et al. (2012). Anti-HER-2 et hormonothérapies dans la prise en charge des cancers du sein: Indications. In: Cancer du sein. Springer, Paris. https://doi.org/10.1007/978-2-8178-0245-9_35

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  • DOI: https://doi.org/10.1007/978-2-8178-0245-9_35

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0244-2

  • Online ISBN: 978-2-8178-0245-9

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