作者: François-Clément Bidard , Kevin Kalinsky , Massimo Cristofanilli , Giampaolo Bianchini , Stephen KL Chia
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摘要: Background: More than two thirds of patients with metastatic breast cancer (mBC) have hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) tumors. Current guidelines recommend combining endocrine therapy (ET), such as an aromatase inhibitor (AI), with an inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6i) as first-line (1L) treatment (Cardoso et al. Ann Oncol 2020). However, drug resistance eventually develops, leading to disease progression. Mutations in the estrogen receptor (ER) alpha gene (ESR1m) result in constitutively active, estrogen-independent ER signaling which can reduce AI efficiency (Reinert et al. Front Oncol 2017). Clinically, ESR1m are associated with acquired resistance to AI as well as more aggressive disease features, including development of visceral metastasis (Gerratana et al. Eur J Cancer 2021). At the initial diagnosis of mBC, the …