Breast cancer, one of the three most common malignancies worldwide, is a disease strongly related with age, with the highest incidence among elderly, postmenopausal women.¹ Approximately 70–80% of breast cancers are estrogen receptor (ER) or progesterone receptor (PgR)-positive and thus potentially sensitive to endocrine therapy (ET). The main international guidelines endorse ET as the preferred first-line option for hormone receptor-positive (HR+) disease in postmenopausal women, even in the presence of visceral disease (but not in cases of visceral crisis or concern/proof of endocrine resistance). At some point of her clinical history, every woman with HR+/HER2 metastatic breast cancer (MBC) will receive one or more ET lines in the context of a sequential strategy.² The choice of the upfront and subsequent agents mainly depends on the type of adjuvant ET as well as the disease-free interval from its completion; these can be aromatase inhibitors (AIs), tamoxifen, or fulvestrant.³ However, almost all women with initially endocrine-sensitive disease will develop a resistance to ET, either as an early failure (de novo resistance), or as a progression after an initial response (acquired resistance).⁴ The optimal sequence of single endocrine agents and combinations with targeted agents is yet to be defined and is a research priority.

中文翻译：

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500 毫克氟维司群治疗激素受体阳性/HER2 阴性转移性乳腺癌绝经后妇女的模式和结果：真实的多中心意大利经验

乳腺癌是世界上最常见的三种恶性肿瘤之一，是一种与年龄密切相关的疾病，在老年、绝经后妇女中发病率最高。¹大约 70-80% 的乳腺癌是雌激素受体 (ER) 或孕激素受体 (PgR) 阳性，因此可能对内分泌治疗 (ET) 敏感。主要的国际指南认可 ET 作为绝经后妇女激素受体阳性 (HR+) 疾病的首选一线选择，即使存在内脏疾病（但在内脏危机或担心/证明内分泌抵抗的情况下）。在她临床病史的某个时间点，每位患有 HR+/HER2 转移性乳腺癌 (MBC) 的女性都将在序贯策略的背景下接受一个或多个 ET 线。²前期和后续药物的选择主要取决于辅助 ET 的类型以及完成后的无病间隔时间；这些可以是芳香酶抑制剂 (AI)、他莫昔芬或氟维司群。³然而，几乎所有最初患有内分泌敏感疾病的女性都会对 ET 产生耐药性，或者作为早期失败（从头耐药），或者作为初始反应后的进展（获得性耐药）。⁴单一内分泌药物和与靶向药物组合的最佳顺序尚未确定，是研究重点。