2024.V1版NCCN指南更新：乳腺癌用药选择.docx

2024.V1版NCCN指南更新：乳腺癌用药选择2024年1月25日，乳腺癌NCCN指南更新至2024.V1版，此次药物治疗方面的更新主要涉及化疗药物的选择和剂量的调整，具体更新内容如下。并且本文汇总了最新版乳腺癌NCCN指南推荐的靶向、免疫药及方案选择，仅供参考。01、术前/辅助治疗方案HER2阴性的三阴性乳腺癌（TNBC）其他推荐方案调整：紫杉醇+卡钳（不同给药方式）调整为2A类证据多西他赛+卡钳删除“仅用于新辅助治疗”，调整为2A类证据National Comprehensive Cancer Network-NCCN Guidelines Version 1.2024 Invasive Breast Cancer° PMierts in th» OMnP0tfi dd MreCa ae petM>rv. ttjt. them m no data On se9jenerg or 2 guide *le<aon Of one agent om te other. MQt>m ma EUde Mge IMIITNBC. The um ofvant PemeIIafneb (cBxy 2A> E B BMOurirB.BINVLPREOPCRATivEzaojuvanttherapyregimens*TherglmnMtdMthetblIocHR2-ogvdMMrc(gory1(xcptwboiMkWd)whenudIn5djuvntMftlng.HEMqeMxRgflkT911s: D<we-dnseAC(doxorubclncycophophmWJfoilowdorpre<MbypclHaxlvcy2vMfcb DM-<tonMAC(doxorub*cirvcyclophophmldfottowdorprc<MbyvrclypcMax<to TC(docUx4andCyclophosphamkJc) OUparib.if90<mUn0BRCA12mutotk°, HtghvitNTNBC:Prcprttv.PembfOliZUmbCMt)OPSgpclltxl,o4lwdbyproprtlvPeenbM以UfnM)cycloptophmMd<Morbkinorpirublcin.foK(Mrdbyacuvatpfnbrokzumab TNBCandEkIWdisaMftocpr«op«ratfvothmpyWHhtaxsne.a*yM>r.andamrcycHne4)MdCbOmOtXfa*:CapociUbIfWUm*jInCfttaCWCumtUnc: D<m-dnwAC<doxorubcincyckphosphmtd) AC(doxofuMcifvcyclophcephamido)vry3WMkS(ctog<xy28) CHF(cycM>h<xphfnldw<hotrxwfluorourcH) ACfollowdbyWMkiypaclitx0ib CapociUbln(TOlntonancothrapyforTNBCafterMuvafitCMmothorapy)OtherRcxwnmcc>dRgimm:ACIollowodbydoco<alv<y3wksbEC(pirublcircyclophosphamMo)ForTNBC:>PacIHaxoICartlOPtotin(various*cduls)(category2A)D0CUx4C«rt>plMbn(CW90ry2A)AdditionalConsMeratfomforTMROCVingProoprativoAduvantThocapy(BlNY-LJ)ABamaMIaNBne乂docatml.PJeBM.rtfpadtod)toWteuhAedtxMMpMMntsduetomo<Sct<auiyg.ryp«»rvMym*ctt11IfWttliUedtofWwWordo<rtM<rt.thentewec*omofatou11v>bomdpacMaieishouldtxtexceedi25n>tn,niscoeptadletocftar>gethe«1rmstationIeQXnCeIoWane(*GOr*xMKR24oetedter>y>IaBoWBdbyAC.cCOngrB<S3ootadg11(Apart)torIyhx<seWItlgsrrrtneBACAfArmiMiorvvxt TNBC.1)2pT2or2pN1dMMMr>jvvtCtwmorMrap/.Or2)MdMldMMaftarp<*>rWvCfwnoihtapy M-poti.H三2wgatumor.if1)24osiMlyeprodtsaftercmcmray(cM90ry2A),ot2)eWUdMflrpropratkthmpyand dnc*lUge.ptfho<ogcMgB.ER”&.Ftumorg<MWSEG>cor*3AjatQuParc)CaIbeusd811cu5&WItIndomotcrawHER2阳性乳腺癌其他推荐方案调整:NCCNNational Comprehensive Cancr Network*新增紫杉醉/卡伯+曲妥珠单抗+帕妥珠单抗NCCNGuidelinesVersion1.2024InvasiveBreastCancerAMrnatM taaM gdoctawl pad*i burvirVbolrd adi>d> mjr to Wtettuled tor Mted paUmk du to mxlcal nMt*y (to. r¾pwnf rMd) If SUtsttiied tor wm。PKIgH or dooaUul. thtn t> w«Mly dose ( atjnrtt>(xnd pacMaiel 6oUd not oMd 125 m0m1.ltB IccaptiblB to tfMrs c adrmtataon MQUeaCO to Uxano <wh or MmUt HER2Urg4td torjy) folowd by ACt PactUT . tBftuznat) m»y ba ooUMred tor patnt "t kMM»k T1 .N0.M0. HER2-poiK (teeMe. PefgJarV to*e not Cfegtlo tor Cthor Standvtf <uwnt regmns due to comorbdOm.9Com<ter CBtendad ad>at rw«M)foovttfng ad>ja »MturunwoontaMng therapy fcr pMianU vt H R-pot. 02poO diMM Wflh a pod rtsk of reamnoe. E ten>t or tddta MSOdalOd *5naratinbMn* who hvAng5 or ado4MAAfwb mt>Mr MrknOMnIt TraMiXimtf)In COmbett3 WG an artracydn * atsodod MttiAgnAcant cardtoc loxc COnCUnWrt um of tr*lu2ur1ab and p»f1uzumM)wff an anrclno SbaJd B wdod.'UPdad muRs from t) antAPHTY Mri in *R2os4s brt roor. wth a rn9an rotow-i f 84 yovt. hM COmrTned Gt gnft Cf add” po<tujnab to IMUajnab Bg ChBmCthOBy r Prgnmg racunenoet 力 tXBc H nods pouhw d MateBIWV-L2 OF 9PREopeRATlVEZADJUVANTTHERAPYREGMflENSaHEMfWv PcMbx4trwtuzum4bf TCH(dcc4UxVcrt>optotifyrMt(umb) TCHP(doctaxVort)opitirtr*stuzumMprtusumab) IfnorldualdlsoasafWrproprMtvothrapyornopr>prattvthrapy:CompiotouptoonyarofHER2tar9tdthrapywMtrastuzumab1(cM90ry1)tprtuzumab IfrduldMsCpropfttvtherapy:Ado4rMtuzumb<ntninIgory1)fonIfdotrxumbmtnkwdkcolinu*dfortoxteity.IMnIrMtuxumab(ctgocy1)1p<iuzumM)tocompMcnyfofthrpy.,hIfnodPotittvatMtUIt>gMg.tr<uwmbprzum>b(cWfloryifUWuIMCfUlnCkcumMfc: DocoUxoiCyclaphospIwnkSetrastuzumab ACfollowedT®IrMtuzumabh(doxorbcincyc*opbopmMIoIIowmIbyPyplutrMtuamb.vhou38us) ACIollowodbyTbtrastuzumabpo<tuzumsbh(doxorubkArVcyclophosphamidofoBowdbypcMulplustrastuzienabpluspertuzumab.vdouSCMaUiM) Nratinlb0(XJUVantXlngonly) P>clitax4trastuzumabPortUZUfnabh AdotrMtuzutnabmtantin(TDM-1)(duvlMttmgOrtfy)OtherRconwnn<MRgmm:ACfoliowodSfdoct>xlbtrastuzumab(doxorubclrVcyclophopamktofoHcwdbydocUxdtrMtuzum«b)ACt/odbydoc*taxlbtrMummbXrtMZUrnt(donJbklnGeoph<*p3nMfoowmlbydocCax4PcWU3Qo"M»MuzumabprtuzumbAddHIo