ESRI-мутация как потенциальный предсказательный маркер для выбора тактики лечения при гормонорезистентном HR+/HER2-негативном раке молочной железы

The analysis of the current strategy for the treatment of advanced HR+/HER2-negative metastatic breast cancer (mBC) was carried out, the criteria for hormone sensitivity and hormone resistance were given, and the changes in the classification of tumors were reflected taking into account the level of expression of estrogen receptors. A detailed characterization of a new potential marker of acquired hormone resistance - activating somatic mutation of the estrogen receptor gene ESR1, leading to constitutive ligand-independent activity of the estrogen receptor is given; describes the predictive and prognostic role of ESR1 mutation, its association with the clinical course of the disease and response to endocrine therapy. The paper presents studies to find the optimal treatment regimen after progression to CDK4/6 inhibitors, including the emergence of ESR1 mutations. The characteristics and key advantages of eribulin chemotherapy in patients with hormone-resistant mBC are presented, and preliminary results of the EMPOWER study on the potential for eribulin use after progression to CDK4/6 inhibitors are presented. This review will help form the concept of a personalized approach to the choice of a treatment strategy for hormone-resistant mBC.