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Models of systemic treatment in breast cancer
H ERRIHANI and all
Department of medical oncology
National institute of oncology RABAT MOROCCO
Breast cancer is the most common women malignancy in the word, and also in
Morocco. Many progresses have been made these last years concerning systemic
treatment, which is used at all stages of the disease: adjuvant, neo-adjuvant or
metastatic setting. Many therapeutic options are available: chemotherapy,
endocrine therapy and targeted therapy.
Adjuvant systemic treatment is indicated according to prognostic and predictive
factors. Taxanes are prescribed in lymph node positive disease, trastuzumab in
her 2 neu tumors, endocrine therapy is indicated in positive hormonal receptors
disease. Primary systemic therapy is indicated in inoperable breast cancer
(locally advanced or inflammatory breast cancer) or to conserve the breast in
operable disease. Prescribed regimens in the neo-adjuvant setting contain
sequential anthracyclines and taxanes, combined with trastuzumab when Her 2neu is positive. In metastatic disease, systemic treatment is the most important
therapeutic arm. Its objective is to improve survival and quality of life. The
choice between all the drugs available is based on Hormonal receptors, Her 2neu status and also according to severity of breast cancer.
Based on a review of the literature and after many workshops heald in the
medical oncology department, a chemotherapy regimens guide has been
developed, including breast cancer potocols. The Lalla Salma Association to
fight against cancer was of a great help, in providing innovative and expensive
drugs to low income patients.