Treatment flow
2022-02-05 15:18:00 15 举报AI智能生成
BC treatment flow
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Her2+ BC
Neo adjuvant
I: TCbHP, THP
II: TCbH, AC-THP, clinical trials
adjuvant
neo adj. pCR
if H in neo adjuvant
I: H
II: HP
if HP in neo adjuvant
I: HP
II: H
neo adj.Non-pCR
if H in neo adjuvant
I: T-DM1, HP
II: H
if HP in neo adjuvant
I: T-DM1, HP
lymph nodes+
I: AC+THP, TCbHP
II: AC-TH, TCbH
III: H-Neratinib
lymph nodes-
high risk(T>2cm) etc.
high risk(T>2cm) etc.
I: AC-TH,TCbH
II: AC-THP,TCbHP
III: H-Neratinib
lymph nodes-
T≤2cm
T≤2cm
I: TC+H
II: wTH
III: chemo-H
HR+ no chemo
II: H+endocrine
mBC
no H before/ qulified to H again
I: THP, TXH
II: H+chemo, pyrotinib+capecitabine
III: H+P+chemo
fail to H
I: pyrotinib+capecitabine
II: T-DM1, lapatinib+capecitabine
III: Neratinib+capecitabine, pyrotinib, TKI+Chemo, H+Chemo
TNBC
Neo adjuvant
I: TAC, AT, TP
II: AC-T, clinical trials: T+PD-(L)1
adjuvant
lymph nodes+
/T>2cm
/T>2cm
I: AC-T, ddAC-ddT
II: TAC, FEC-T,chemo-capecitabine
III: FAC*6
lymph nodes-
and T≤2cm
and T≤2cm
I: AC, TC
II: AC-T
mTNBC
failed to A treatment
I: T single: nab-paclitaxel, docetaxel，paclitaxel
combo: TX, GP, GT, TP
combo: TX, GP, GT, TP
II: single: X, N, G, Etoposide
combo: nab-paclitaxel +PD-(L)1;T+Beva
combo: nab-paclitaxel +PD-(L)1;T+Beva
III: paclitaxel liposomes, Olaparib, Doxorubicin liposomes, chemo+PD-1
failed to A and T treatment
I: single: X, N, G
combo: NP, GP, NX
combo: NP, GP, NX
II: single: Eribulin, nab-paclitaxel, Etoposide
combo: Utidelone+X, X+beva, nab-paclitaxel+chemo
combo: Utidelone+X, X+beva, nab-paclitaxel+chemo
III: paclitaxel liposomes, Doxorubicin liposomes,
HR+
neo adjuvant
I: TAC, AT
II: AC-T
if not suitable for chemo
postmenopausal
I: AI
II: AI+CDK4/6i,Fulvestrant
pre-menopausal
II: OFS+AI, OFS+AI+CDK4/6i
adjuvant
Chemo
high risk: 1, lymph nodes≥4+
2, lymph nodes 1-3 with other risk fators
2, lymph nodes 1-3 with other risk fators
I: AC-T,ddAC-ddT
II: TAC, FEC-T
III: FAC*6
low risk: 1, lymph nodes1-3+; 2, Ki-67 high (≥30%）
3, T>2cm; 4, age<35 yo
3, T>2cm; 4, age<35 yo
I: AC, TC
II: AC-T
Endocrine therapy
postmenopausal
I: AI: 5 years, TAM then AI 5 years
II: TAM 2-3 years -- AI 2-3 years
III: TAM 5 years
intensive therapy if high risk
1, lymph node+; 2, G3; 3, other high risk fators
1, lymph node+; 2, G3; 3, other high risk fators
I: AI
II: switch to TAM
pre-menopausal
low rish(all): 1, lymph nodes-; 2, G1; 3, T≤2cm; 4, low Ki-67
TAM 5 years
meet one of: 1, G2 or G3; 2, lymph nodes 1-3; 3, T>2cm
I: OFS+TAM years
II: OFS+ AI 5 years
III: TAM
lymph nodes≥ 4
I: OFS+AI 5 years
II: OFS+TAM 5 years
III: TAM
mBC
no endocrine before
I: AI+CDK4/6i, Fulvestrant
II: AI, Fulvestrant+CDK4/6i
III: TAM
TAM failed
I:AI+CDK4/6i, AI+Chidamide, Fulvestrant+CDK4/6i
II: AI, Fulvantrant
NSAIDs AI failed
I: SAI+Chidamide, Fulvestrant+Abemaciclib, Fulvestrant+Palbociclib
II: SAI+CDK4/6i, Fulvestrant, SAI+Everolimus
III: SAI, TAM, Toremifene，Progestogen
SAIDs AI falied
I: Fulvestrant+Abemaciclib, Fulvestrant+Palbociclib
II: Fulvestrant, NSAI + CDK4/6i
III: NSAIDs, TAM or Roremifene, Progestogen
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