Academia M. 132

Presente y Futuro del Tratamiento del CM

A Academia Nacional de Medicina de Colombia

En los países desarrollados del mundo, donde el acceso al tratamiento del CM está menos obstaculizado por barreras del sistema de salud, la mortalidad por CM ha disminuido progresivamente entre los años noventas del siglo pasado y la actualidad (9,131). En el CM metastásico con RH positivos, específicamente, la supervivencia prácticamente se ha duplicado, pasando de 32 a 57 meses (132).

Aunque esta mejoría puede ser atribuible a muchos factores, no hay duda de que el desarrollo de nuevos fármacos ha tenido un papel fundamental. Sin embargo, todavía existen importantes preguntas que contestar, particularmente en aquellas pacientes que desarrollan resistencia al tratamiento hormonal.

Las vías futuras de investigación incluyen el estudio y tratamiento de tumores con mutaciones en el RE, el hallazgo de biomarcadores, y el uso de biopsias líquidas, con la intención de desarrollar tratamientos personalizados que permitan mejorar la supervivencia de estas pacientes.

(Lea También: Perspectiva Actual de la Cirugía Oncológica)

Conclusiones

La introducción y posterior evolución de muchos agentes endocrinos desde la década de 1970 ha transformado el tratamiento de las mujeres con CM (Figura 3).

Estos avances han logrado un cambio en la práctica clínica actual, pasando de cirugías ablativas y quimioterapias agresivas, a tratamientos dirigidos y mejor tolerados, lo que ha mejorado la supervivencia y la calidad de vida de las pacientes con CM.

Conflictos de interés

Yanin Chávarri Guerra ha recibido financiamiento para investigación de Roche y apoyo de viáticos de Pfizer. Los demás autores se declaran sin conflictos de interés.

Agradecimientos

Agradecemos a la diseñadora Luí Balmonte por el diseño y elaboración de las figuras 1 y 2.

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Recibido: Octubre 27, 2020
Aceptado: Noviembre 03, 2020

Correspondencia:
Yanin Chávarri Guerra
yaninchg@gmail.com

Academia Nacional de Medicina de Colombia

Revista científica arbitrada de la Academia Nacional de Medicina de Colombia. Fundada como Revista Médica en 1873. La Academia Nacional de Medicina es una institución científica de duración indefinida, sin ánimo de lucro, de derecho privado, con Personería Jurídica otorgada por el Ministerio de Justicia mediante Resolución 1241 del 29 de abril de 1958, cuya misión es contribuir al estudio y progreso de la medicina, de la educación médica y la investigación.

Anterior Siguiente

Conclusiones

Conflictos de interés

Agradecimientos

Referencias

1. (IARC) IA for R on C, World Health Organization (WHO). Breast Cancer. Source: Globocan 2018. World Heal Organ. 2018;876:2018-2019.

2. Bloom D. Breakaway: The global burden of cancer -challenges and opportunities. A report from the Economist Intelligence Unit Limited 2009. London: The Economist; 2009.

3. Bravo LE, García LS, Carrascal E, Rubiano J. Burden of breast cancer in Cali, Colombia: 1962-2012. Salud Publica Mex. 2014;56(5):448-456.

4. Soto-Perez-de-Celis E, Chavarri-Guerra Y. National and regional breast cancer incidence and mortality trends in Mexico 2001-2011: Analysis of a population-based database. Cancer Epidemiol 2016;41:24-33

5. Duarte C, Salazar A, Strasser-Weippl K, de Vries E, Wiesner C Krush L et al. Abstract P5-13-12: Breast cancer in Colombia: A growing challenge for the health care system. Cancer Res.:1-6.

6. SEER*Explorer: An interactive website for SEER cancer statistics [Internet]. Surveillance Research Program NCI [consultado 14 septiembre 2020].Disponible en: https://seer.cancer.gov/explorer/.

7. Villarreal-Garza C, Aguila C, Magallanes-Hoyos MC et al. Breast Cancer in Young Women in Latin America: An Unmet, Growing Burden. Oncologist. 2013;18(S2):26-34.

8. Waks AG, Winer EP. Breast Cancer Treatment: A Review. JAMA. 2019;321(3):288-300.

9. Shumway DA, Sabolch A, Jagsi R. Breast Cancer. Med Radiol. 2020:1-43. 10.

10. Obeidat F, Ahram M, Al Khader A et al. Clinical and histopathological features of breast cancer in Jordan: Experience from a tertiary care hospital. J Pak Med Assoc. 2017;67(8):1206-1212.

11. Goldhirsch A, Winer EP, Coates AS, et al. Personalizing the treatment of women with early breast cancer: Highlights of the st gallen international expert consensus on the primary therapy of early breast Cancer 2013. Ann Oncol. 2013;24(9):2206-2223.

12. Sainsbury R. The development of endocrine therapy for women with breast cancer. Cancer Treat Rev. 2013;39(5):507-517.

14. Singh G. Oophorectomy in Breast Cancer-Controversies and Current Status. Indian J Surg. 2012;74(3):210-212.

15. Russell PW. Hypophysectomy in metastatic breast carcinoma. J Kans Med Soc. 1955;56(9):481 485.

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