トリプルネガティブ乳癌Q＆A

出版社： 医歯薬出版
著者：
発行日： 2023-07-10
分野： 臨床医学：一般  >  癌/腫瘍一般
ISBN： 9784263732144
電子書籍版： 2023-07-10 （第1版第1刷）
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商品紹介

乳癌のサブタイプで，「トリプルネガティブ乳癌(Triple Negative Breast Cancer:TNBC)」は，ホルモン療法や分子標的治療薬のトラスツズマブも効果がなく，また癌の増殖能力が高いケースが多く，唯一効果が期待できる抗がん剤においても治療薬が限られてしまうため，「予後不良」となることが多い．
これは乳癌全体における約10%を占めており，乳癌医療における最も重要なアンメットニーズの一つとなっている．
本書では，予後不良な「トリプルネガティブ乳癌」に焦点を当て，治癒・改善を目指すための必須事項について，わかりやすい「Q&A形式」で詳しく解説している．

目次

  • I．総論
    　　1．TNBCの特徴について教えてください
    　　2．TNBCにはどのような腫瘍のサブタイプがありますか?
    　　3．TNBCにおける免疫機構について教えてください
    　　4．TNBCにかかりやすい患者のタイプについて教えてください
    　　5．TNBCの症状にはどのようなものがありますか?
    　　6．TNBCの転移と再発について教えてください
    　　7．TNBCの再発の様式について教えてください
    　　8．TNBCの生存率について教えてください
    　　9．TNBCの予後良好・不良因子について教えてください
    　　10．TNBCに対する予防法はありますか?
    II．診断
    　　11．TNBCの診断フローについて教えてください
    　（遺伝子診断）
    　　12．TNBCに対するBRCA遺伝子検査について教えてください
    　　13．TNBCに対する遺伝性乳癌マルチジーンパネル検査について教えてください
    　　14．TNBCに対するがんゲノム遺伝子パネル検査について教えてください
    　（病理診断）
    　　15．TNBCでみられる病理組織型について教えてください
    　　16．TNBCでみられる病理組織型と予後との関連について教えてください
    　　17．TNBCの特殊型（炎症性，浸潤性，…）にはどのようなものがありますか?
    　　18．TNBC検査におけるKi-67の意義について教えてください
    　　19．TNBCに対する病理検査のHER2との関連について教えてください
    　　20．TNBCに対するTIL（腫瘍浸潤リンパ球）について教えてください
    　　21．PD-L1判定について教えてください
    　（画像診断）
    　　22．TNBCのマンモグラフィについて教えてください
    　　23．TNBCの超音波診断について教えてください
    　　24．TNBCのMRI診断について教えてください
    　　25．TNBCのPET診断について教えてください
    III．治療
    　　26．TNBCの治療フローについて教えてください
    　（手術療法）
    　　27．TNBCの手術療法の適応基準，除外基準について教えてください
    　　28．術前化学療法が奏効した場合の手術について教えてください
    　　29．術前化学療法が奏効しなかった場合の手術について教えてください
    　（放射線療法）
    　　30．TNBCに対する放射線療法の適応はどのような場合でしょうか?
    　　31．TNBCの乳房照射の適応について教えてください
    　　32．TNBCに対するブースト照射について教えてください
    　　33．TNBCの乳房全切除術後放射線治療（PMRT）の適応について教えてください
    　　　　　(1)（※術前薬物療法なしの場合）
    　　34．TNBCの乳房全切除術後放射線治療（PMRT）の適応について教えてください
    　　　　　(2)（※術前薬物療法ありの場合）
    　　35．TNBCの内胸リンパ節照射の適応について教えてください
    　（薬物療法）
    　　36．再発リスクによる周術期薬物療法の違いについて教えてください
    　　37．TNBCの特殊型の薬物治療について教えてください
    　　38．術前化学療法の目的・適応について教えてください
    　　39．術前化学療法の臨床効果と予後の関係について教えてください
    　　40．術前化学療法の病理組織学的効果と予後の関係について教えてください
    　　41．TNBCに対して術前治療よりも手術先行を考慮するのはどのような場合ですか?
    　（免疫療法）
    　　42．免疫チェックポイント阻害薬はどのような場合に使いますか?
    　　43．PD-L1を発現する切除不能局所進行または転移TNBCに対する免疫化学療法について教えてください
    　　44．術前免疫化学療法で残存病変がない場合の期待される予後について教えてください
    　　45．術前免疫化学療法で残存病変がある場合，残存腫瘍量と予後の関係について教えてください
    　　46．術前免疫化学療法で残存病変がある場合のTNBCの追加治療はどう考えたらよいでしょうか?
    　　　　　(1)（※gBRCA病的バリアントなしの場合）
    　　47．術前免疫化学療法で残存病変がある場合のTNBCの追加治療はどう考えたらよいでしょうか?
    　　　　　(2)（※gBRCA病的バリアントありの場合）
    　　48．PD-L1の検査方法について，SP142と22C3の違いを含めて教えてください
    　　49．アテゾリズマブとペムブロリズマブの違いを教えてください
    　　50．免疫チェックポイント阻害薬の有害事象について教えてください
    　　51．免疫チェックポイント阻害薬を用いる際のポイントについて教えてください
    　　　　　(1)（※事前の準備）
    　　52．免疫チェックポイント阻害薬を用いる際のポイントについて教えてください
    　　　　　(2)（※irAEの早期発見・早期対策）
    　　53．免疫チェックポイント阻害薬を用いる際のポイントについて教えてください
    　　　　　(3)（※毒性への対応）
    　（化学療法）
    　　54．TNBCの化学療法にはどのようなものがありますか?
    　　55．TNBCに対する化学療法のレジメンについて教えてください
    　　56．Dose dense化学療法の適応について教えてください
    　　57．TNBCに対するプラチナ製剤の役割と感受性について教えてください
    　　58．gBRCA病的バリアントがあるTNBCに対するプラチナ製剤の役割と感受性について教えてください
    　（PARP阻害薬）
    　　59．PARP阻害薬の作用メカニズムについて教えてください
    　　60．BRCA遺伝子変異を有する転移性TNBCに対する化学療法について教えてください
    　　61．転移進行TNBCに対するPARP阻害薬の適応について教えてください
    　　62．PARP阻害薬の毒性とその対応について教えてください
    　　63．BRCA病的バリアントを有する転移進行TNBCに対する治療のシーケンスについて教えてください
    　（新しい開発中の治療法）
    　　64．TNBCにおけるTrop-2発現について教えてください
    　　65．TNBCにおける抗Trop-2 ADC（antibody-drug-conjugate）について教えてください
    　　66．TNBCにおける抗HER2 ADCについて教えてください
    　　67．免疫療法とPARP阻害薬の併用について教えてください
    　　68．TNBCに対する新しい免疫療法について教えてください
    　　69．TNBCに対するその他の新しい標的治療について教えてください
    　（転移・再発）
    　　70．De novoステージIVの転移性TNBCに対する化学療法について教えてください
    　　71．骨に転移した場合のde novoステージIVのTNBCに対する治療法について教えてください
    　　72．局所再発した場合のTNBCに対する治療法について教えてください
    　　73．脳に転移した場合のTNBCに対する治療法について教えてください
    　　74．転移・再発TNBC治療のシーケンスについて教えてください
    　　75．転移・再発TNBCに対してプラチナ製剤は有効ですか?
    　　76．転移性TNBCに対するリキッドバイオプシーの意義について教えてください
    　　77．転移巣の再生検の意義とその結果による治療方針について教えてください
    　　78．BRCA遺伝子変異を有し，PD-L1陽性だった場合の治療の流れについて教えてください
    IV．術後フォロー
    　　79．TNBC術後の定期検診はどのような頻度で実施しますか?
    　　80．術後フォローの内容について教えてください
    　　81．リキッドバイオプシーは再発予測に有用か教えてください
    V．その他
    　　82．TNBCの患者の妊孕性温存について教えてください
    　　83．採卵のための調節卵巣刺激はTNBCに影響があるでしょうか?
    　　84．TNBCの患者にLH-RHaを追加することの意義について教えてください
    　　85．検診で発見される無症候性乳癌に占めるTNBCの割合について教えてください
    　　86．無症候性に発見されるTNBCの特徴について教えてください
    　　87．潜在性TNBCが発見された場合の診断フローについて教えてください
    　　88．潜在性TNBCが発見された場合の治療法について教えてください
    　　89．TNBCと人種の関係について教えてください
    　　90．TNBCのリスク低減予防について教えてください
    　　91．TNBCの化学予防について教えてください
    　　92．TNBCのサバイバーシップについて教えてください
    　　93．原発性乳癌の治療にかかるコストについて教えてください
    　　94．再発TNBCの治療にかかるコストについて教えてください

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

I. 総論

P.6 掲載の参考文献
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P.10 掲載の参考文献
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3) Vincent MT de Jong et al. Prognostic value of stromal tumor-infiltrating lymphocytes in young, node-negative, triple-negative breast cancer patients who did not receive (neo)adjuvant systemic therapy. Clin Oncol 2022;40(21):2361-74. [PMID:35353548]
 
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P.15 掲載の参考文献
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P.18 掲載の参考文献
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P.23 掲載の参考文献
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P.25 掲載の参考文献
1) Kinoshita T et al. Comprehensive prognostic report of the Japanese Breast Cancer Society Registry in 2004. Breast Cancer 2016;23:39-49.
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2) Li X et al. Triple-negative breast cancer has worse overall survival and cause-specific survival than non-triple-negative breast cancer. Breast Cancer Res Treat 2017;161(2):279-87.
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P.32 掲載の参考文献
1) 国立がん研究センター研究開発費による研究班. 科学的根拠に基づくがんリスク評価とがん予防ガイドライン提言に関する研究. http://epi.ncc.go.jp/cgi-bin/cms/public/index.cgi/nccepi/can_prev/outcome/index
 
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II. 診断

P.35 掲載の参考文献
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P.37 掲載の参考文献
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P.39 掲載の参考文献
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P.53 掲載の参考文献
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III. 治療

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IV. 術後フォロー

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V. その他

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