Highlights of Breast and Prostate Cancer Treatment In recent years, the incidence of hormone-dependent malignancies, led by breast cancer and prostate cancer, has been increasing year by year worldwide and is at the forefront of the malignancy spectrum in men and women, respectively. How to standardize the clinical diagnosis and treatment of these tumors under the guidance of evidence-based medicine is the primary problem we face. On September 11, the 3rd Public Forum on Hormone Dependent Tumors was held in the Conference Center of the First People’s Hospital of Shanghai Jiaotong University. The theme of this forum was “Innovative Cancer Therapy for Tomorrow”. The experts focused on new methods, new concepts and difficult and hot issues in the diagnosis and treatment strategies of hormone-dependent tumors, and conducted extensive and in-depth studies and discussions through academic lectures and case sharing. Prostate cancer is the most common malignant tumor in men in western countries, accounting for the second leading cause of cancer death in men. Breast cancer is the most common malignant tumor in women in both western countries and China, and has become the number one killer that seriously threatens women’s health. Treatment options for limited high-risk prostate cancer Treatment option-option 1: Prostate cancer debulking therapy (ADT) combined with external radiation therapy (EBRT) is associated with better disease regression than EBRT or ADT alone. Treatment option-option2: Radical prostate cancer treatment requires clean pelvic lymph node dissection and better surgical results when the margins are negative. Robotic-assisted radical prostate cancer treatment is more effective but relatively more costly. The choice of initial treatment: radical surgery (RP) and radiotherapy (RT) are compared. RP is superior to RT (+/-ADT) although it has a better survival rate, but it should be analyzed specifically according to individual differences and needs. Postoperative treatment: postoperative radiotherapy requires strict grasp of radiotherapy indications. The effect of early radiotherapy is better than late radiotherapy; there is no clear conclusion on whether endocrine therapy is needed after surgery, and some studies have shown that ADT can delay the time of biochemical recurrence with relatively good efficacy. Endocrine therapy for breast cancer Endocrine therapy for breast cancer mainly involves blocking estradiol and estradiol receptor binding. The role of endocrine therapy in the treatment of breast cancer, whether premenopausal or postmenopausal, is well established. Tamoxifen (Tam) is more effective at 10 years than at 5 years, and 10-year Tam therapy remains a guideline recommended option. The benefit of 5 years of Tam + 5 years of aromatase inhibitor (AI) therapy is more pronounced in patients with a high risk of recurrence and metastasis. Premenopausal patients benefit more from treatment than postmenopausal patients. Age is an absolute prognostic factor for breast cancer patients, especially patients younger than 35 years have a poor prognosis, and patients before 35 years benefit more from combined ovarian function suppression (OFS) therapy. When HER2 is highly expressed, the effect of endocrine therapy is significantly reduced. In breast cancer patients with visceral metastases, endocrine therapy still has good efficacy. Advances in surgical treatment of early-stage breast cancer For early-stage breast cancer, surgery remains the basis of comprehensive treatment. The selection of the size of the incision margin in breast-conserving surgery is based on the guidelines and depends on the patient’s specific situation. Breast-conserving surgery for breast cancer has two risks: one is more likely to obtain a positive margin, and the other is more likely to have local recurrence when the margin is negative; the negative margin is important and the biological characteristics of the tumor are more important. Prof. Lu emphasized that negative cut margin means the pathological cut margin is not positive. In addition, Prof. Lu emphasized that surgical treatment can change the survival rate of breast cancer patients. Breast cancer immune translation research from basic to clinical issues related to breast cancer immune translation from basic research to clinical application. 2013 Science listed tumor immunotherapy as one of the six scientific areas of interest. In immunotherapy of breast cancer, tumor infiltrating lymphocytes (TILs) and immune-related gene labeling are associated with prognosis in certain breast cancer subtypes. tILs (either within the tumor or in the interstitium) are positively associated with invasive ductal carcinoma, high tissue grouping, hormone receptor negativity, and Ki67 expression. In triple-negative breast cancer (TNBC), TILs enrichment was associated with a better prognosis in early TNBC. There are two main therapeutic immune response pathways in breast cancer: blockade of PD-1 and CTLA-4 binding to ligands. PD-L1-positive tumors are more likely to benefit from anti-PD-L1 monoclonal antibodies. The combination of the intrinsic immune activators Anti-PD-1 and Anti-CTLA-4 is a new approach to immunotherapy. Impact of drug clinical trials on clinical practice Four drug clinical trials of endocrine therapy for breast cancer. results of the PALOMA3 trial showed that Palbociclib (CDK inhibitor) is well tolerated and safe, and that combining with fulvestrant is an effective treatment option for women with progressive cancer in endocrine therapy, but whether this trial is effective in Asians remains to be studied. marianne The preliminary results of the phase III randomized clinical trial showed that pertuzumab did not further improve the efficacy of trastuzumab conjugated to the cytotoxic drug DM1 (T-DM1), and T-DM1 was not superior to trastuzumab + paclitaxel (HT) regimen in the early phase. The importance of selecting the right population to conduct the right trial. The trial protocol for lenatinib adjuvant therapy for HER2-positive early-stage breast cancer was modified several times, and eventually the original trial design was reinstated with a call for five-year follow-up, which is controversial as to whether it can change clinical practice. These four trials shared by Prof. Hu suggest that we clinicians should pay more attention to drug trials so that the results can be more applied to clinical practice. This public forum focused on clinical progress and translational research, which contributed to promoting the comprehensive treatment level of hormone-dependent tumors in China, keeping up with the development direction of basic research, and improving the concept of standardized, individualized and multidisciplinary integrated treatment of hormone-dependent tumors in clinical practice in China, as well as promoting and strengthening international academic exchanges and cooperation.