How to choose the drugs for breast cancer chemotherapy?

Rising incidence of breast cancer, cancer of women in China accounts for the first or second place. Although the treatment is not a small improvement, many patients still eventually die of diffusion transfer, this is the main reason for treatment failure, and the current solution to this problem is to develop more effective ways to produce more high efficacy and low toxicity of chemotherapy drugs, we look forward to In the new century, the pharmaceutical sector has a greater contribution in this regard.

Treatment of breast cancer are surgery, chemotherapy (chemotherapy), radiation therapy (radiotherapy) and biological treatment methods, clinical stage of disease must be based sooner or later, choose the combination of different methods to select a reasonable time, than a single method is effective. In a variety of cancers, breast cancer is relatively sensitive to anticancer drugs of tumor, so the comprehensive treatment of chemotherapy in breast cancer have always played an important role. For most surgery, chemotherapy can be used before or after surgery, the metastatic spread of late has been who is the primary means of chemotherapy.

If chemotherapy, what drugs chosen course is the key. After several decades of research, more effective drugs have proven no less than twenty species, of which about 50% efficient high-class drug Adriamycin (doxorubicin, epirubicin, doxorubicin than the soft ), Taxol (paclitaxel, Taxol, Taxotere, paclitaxel), vinorelbine and so on. Efficiency of 20 to 50% of the moderate and effective drugs cisplatin, cyclophosphamide, fluorouracil, methotrexate, mitomycin, thiotepa, vincristine and so on. Another effect is low, but can enter the brain BCNU treatment of brain metastasis, such as cyclohexyl nitrosourea.

Studies have shown that rational use of several drugs in combination chemotherapy is superior to single drug therapy, but combination therapy should follow the following principles:

1. Which must be valid for each drug used alone;

2. Some point of drug proliferation in the process of cell division in different time slots;

3. To use different types of drug toxicity, the accumulation of several non-overlapping toxicity;

4. Used by the application of the longer-term clinical studies have confirmed the effective programs.

According to the principle of combination therapy, the higher efficacy of the current programs at home and abroad have recognized two categories:

1.CMF (methotrexate, cyclophosphamide, fluorouracil) scheme, effective from 49 to 62%.

2.CAF (Adriamycin class, cyclophosphamide, fluorouracil) program, effective 50 to 75%;

The former effect is higher but the greater toxicity of doxorubicin on the heart. The second generation was significantly lower toxicity of epirubicin, but the price too high. Although less efficient CMF program, but many in the treatment of breast cancer program, the program is still better, and less toxic, the current situation of China-based, commonly used in early clinical or pathologic axillary lymph node biopsy see less in three cases. Of the tumor before surgery or axillary lymph node metastases greater than 5cm turn serious Ⅱ or Ⅲ patients, or pathological examination after more than four axillary lymph nodes of patients with advanced, multi-class advocate application of the program with doxorubicin. Of course there are many other effects similar to these two programs, but far from the first two applications have common.

Also worth mentioning is that for the research progress of anti-cancer drugs quickly, higher efficacy, lower toxicity of new drugs are emerging, such as the aforementioned high-class, Taxol, vinorelbine, are showing encouraging good curative effect. Clinical application in recent years gradually increased, but after a short application time, 5 years is better than the aforementioned long-term efficacy is yet to be verified. And expensive, costing several thousand dollars per month or even a million, it is more as a second-line drugs currently used in place of resistance to first-line drugs, or late period and cases of metastatic spread has occurred, and often has been tried and tested with doxorubicin combined classes in order to improve the long-term efficacy.

Also worth mentioning that, breast cancer and ovarian function, mainly referring to ovarian estrogen secretion more closely related to estrogen patients often progress to stimulate or promote the role of cancer, especially when the cancer cells contain estrogen compared with receptor binding, the more vulnerable to the effects of estrogen. Study found that more than half of patients with breast cancer with this receptor, if you stop the estrogen receptor binding, the hormone can not rely on this will slow the growth of cancer cells or even shrink.

Therefore, the clinical detection of estrogen receptor-positive patients given appropriate medication to prevent a combination of both, this treatment is endocrine therapy in breast cancer plays an important role, indeed to receive a considerable effect, has been widely used receptor positive phases of the treatment of breast cancer. Representation of the drugs tamoxifen therapy (tamoxifen), on receptor-positive patients more than 60% efficiency, but also those such as the long-term medication after the effective failure has developed the second and third line drug to replace it continue to play a certain effect.