Hormonoterapia en cáncer de mama metastásico. Revisión de la Evidencia y Abordaje Terapéutico en el Instituto Nacional de Cancerología, Bogotá - Colombia
DOI:
https://doi.org/10.35509/01239015.747Palabras clave:
cáncer de mama metastásico, receptores hormonales positivos, HER2 negativo, agentes hormonales antineoplásicosResumen
El 16.9% de las pacientes con cáncer de mama, que ingresan a la Unidad Funcional de Mama y Tejidos Blandos del Instituto Nacional de Cancerología (INC), se presentan con enfermedad metastásica. El desarrollo de las terapias blanco ha modificado radicalmente el enfoque terapéutico en este grupo de pacientes. Se realizó una búsqueda de la literatura seleccionando los ensayos clínicos controlados y aleatorizados fase 3, las revisiones sistemáticas y los metaanálisis, sobre el tratamiento sistémico para el cáncer de mama metastásico con receptores hormonales positivos (RH+) y receptor HER2 negativo (HER2).
Se pusieron filtros a la búsqueda para identificar únicamente los artículos publicados a noviembre de 2020 y en idioma inglés. Posteriormente, se socializó la revisión de la evidencia al interior de las Unidades Funcionales (UF) de Mama y Tejidos Blandos y Oncología clínica. Finalmente, se realizó una discusión académica en la cual se establecieron los cambios en el abordaje terapéutico de las pacientes con cáncer de mama luminal, HER2 negativo, metastásico. En los últimos años, el conocimiento de la biología molecular del cáncer de mama ha permitido el desarrollo de múltiples terapias blanco (iCDK4/6, iPI3KCA, inhibidores del mTOR), que combinadas con la terapia hormonal, mejoran los desenlaces oncológicos de las pacientes con enfermedad metastásica (supervivencia libre de progresión y supervivencia global).
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