编者按：在乳腺癌领域，BRCA基因突变患者的治疗一直是研究热点。近日，在SABCS大会上，来自意大利热那亚大学圣马蒂诺医院的Matteo Lambertini教授就BRCA突变乳腺癌的治疗最新成果进行了深度分享（摘要编号：GS1-08）。本研究旨在探讨年轻BRCA突变乳腺癌患者中，采取风险降低手术（包括预防性乳腺切除术和预防性输卵管卵巢切除术）对其生存结局的影响。研究者收集并分析了来自全球109个中心、5290名年轻BRCA突变乳腺癌患者的数据，为这一特殊患者群体的癌症风险管理策略提供了重要证据。肿瘤瞭望在SABCS大会现场采访了Matteo Lambertini教授，并邀请他分享其关注的大会亮点内容。

 

 

Could you please briefly introduce yourself as well as your field and research direction.

 

Matteo Lambertini教授：大家好，我叫Matteo Lambertini，是一名肿瘤内科医生，也是意大利热那亚大学圣马蒂诺医院的肿瘤内科副教授。

 

Hello，everyone.My name is Matteo Lambertini.I’m a medical oncologist and associate professor in medical oncology at the University of Genoa，San Martino Hospital in Genoa，Italy.

 

 

Could you please briefly introduce the research you presented during this meeting?

 

Matteo Lambertini教授：在2024年圣安东尼奥乳腺癌研讨会（SABCS）上，我们展示了一项大型国际核心研究的成果。该研究纳入了5200多名确诊的乳腺癌患者，这些患者确诊时年龄均在40岁及以下，并且均携带BRCA基因的生殖系致病突变。因此，这些患者属于年轻的BRCA突变携带者，并已被确诊患有乳腺癌。在这次特定的分析中，我们重点研究了预防性手术的作用，特别是其与生存结局之间的关联。

 

 

主要结果显示，无论是预防性乳腺切除术还是预防性输卵管卵巢切除术，都显著改善了总体生存（OS）率、无病生存率（DFS）以及无乳腺癌间期（BCFI）。这种改善在所有患者亚组中均表现出明显的优势。然而，需要特别指出的是，这些数据应针对特定患者群体加以应用，即携带BRCA突变并在年轻时确诊乳腺癌的女性。

 

 

At the San Antonio Breast Cancer Symposium 2024，we have presented the results of a large international core study that included more than 5，200 patients with diagnosis of breast cancer at a young age，so 40 years or less.And all of them were known to carry a germline BRCA pathogenic variant in the BRCA genes.So they were young BRCA carriers with diagnosis of breast cancer.And in this specific analysis，we focused on the role of risk-reducing surgeries，and specifically we looked into the association between risk-reducing surgeries and survival outcomes.And the main results of this analysis have been that both risk-reducing mastectomy as well as risk-reducing salpingophorectomy were associated with significant improvement in overall survival（OS），disease-free survival（DFS），and breast cancer-free interval（BCFI），with a major advantage that was observed in all the patient subgroups.But these are data，again，that should be considered for a special patient population，so those women that are BRCA carriers and have been already diagnosed with breast cancer at a young age.

 

 

And in the field of your expertise，what are the significance of the advancement and the groundbreaking research presented at this conference that deserve attention?

 

Matteo Lambertini教授：在SABCS大会上，有很多乳腺癌领域的重要研究成果进行了展示。在首日的全体会议（General Session 1）上，EMBER-3研究结果公布，该研究数据同期在《新英格兰医学杂志》（The New England Journal of Medicine）上正式发表（摘要编号：GS1-01）。这项研究探讨了一种名为Imlunestrant的口服选择性雌激素受体降解剂（SERD）在治疗HR+/HER2-且对内分泌治疗耐药的晚期乳腺癌患者中的疗效。在这项研究中，研究者探索了Imlunestrant作为单药治疗或联合阿贝西利治疗的效果，并将其与标准内分泌单药治疗（如氟维司群或芳香化酶抑制剂）进行了比较。研究结果最终发表在《新英格兰医学杂志》上，该研究数据非常重要，可能会对临床实践产生变革性影响。

 

 

这是一个多学科的盛会，深受各领域专家学者的欢迎。其不仅展示了在肿瘤医学领域的新进展，还涵盖了外科、放疗以及癌症幸存者管理等其他领域的最新动态。圣安东尼奥乳腺癌研讨会提供了丰富的内容，值得大家密切关注。

 

At the San Antonio Breast Cancer Symposium，we have had a lot of important trials presented in the breast cancer field.During the first day general session，we had a publication in the New England Journal of Medicine of the results of the EMBER-3 trial investigated an oral SERD called Imlunestrant in the management of patients with Hormone receptor-positive，HER2 negative，advanced breast cancer with endocrine-resistant disease.And in this trial，the authors have investigated the benefit of this SERD single-agent or in combination with abemaciclib as compared to standard single-agent endocrine therapy，so fulvestrant or aromatase inhibitors.This ended in The New England publication，so very important data that can be practice-changing.

 

But this conference is also very much appreciated because it’s a very multidisciplinary event in which we have news not only in the medical oncology field，but also in other fields，including surgery，including radiotherapy，as well as survivorship.So many，many news to be followed at the San Antonio Breast Cancer Symposium.

 

 

So are there any valuable insights that you gained from this conference that you can share with our audience?And how will those insights influence your clinical practice or future research directions?

 

Matteo Lambertini教授：是的，根据本次圣安东尼奥乳腺癌研讨会上展示的数据，我们可以说，“优化”是一个关键词，即患者治疗优化。这意味着我们需要在两方面做出努力：一方面，对于不需要过多治疗的患者，尽量减少治疗负担；另一方面，对于需要更多治疗的患者，适时升级治疗以满足她们的需求。会议上有许多报告聚焦于这两个方向的研究，包括局部治疗和全身治疗的升级或降级策略。这些研究将对我们优化乳腺癌患者的治疗方式带来很大帮助，从而进一步改善患者的治疗。

 

Yeah，based on the data presented at the San Antonio Breast Cancer Symposium，we say that the critical word is optimization，treatment optimization.So trying to improve the way we care about our patients with breast cancer in terms of trying to reduce the burden of treatment when not so much treatment is needed.And on the other side，to escalate the treatments to doing something more for those women that require more treatment.There has been a lot of presentation at the conference on studies in these two directions.So escalation or de-escalation of local treatment as well as systemic therapies that will definitely help us improve in the way we care about our patients with breast cancer and so to optimize the treatment of our patients.

 

Matteo Lambertini

意大利热那亚大学圣玛帝诺医院肿瘤内科副教授和医学顾问