[Expert consensus on off-label use of small molecule anti-angiogenic drugs in the treatment of metastatic breast cancer].

Breast cancer is the most common cancer in the world, and 5-year survival rate of metastatic breast cancer is about 20%. The treatment of metastatic breast cancer is mainly chemotherapy, endocrine therapy and targeted therapy. However, after multiline treatment, patients with MBC especially the triple negative breast cancer face the problem of drug resistance. Tumor angiogenesis theory suggests that blocking angiogenesis can inhibit tumor growth and migration. Based on this, angiogenesis treatment strategy is proposed. Antiangiogenic drugs mainly include biological macromolecular drugs targeting vascular endothelial growth factor (VEGF) or vascular endothelial growth factor receptor (VEGFR) and small molecule VEGFR inhibitors. Angiogenesis is known to play a key role in the growth and metastasis of breast cancer. Therefore, anti-angiogenetic therapy has potential in metastatic breast cancer patients. Since the approval of tumor drug indications by NPMA in China is often later than the release of the latest research data, the National Health Commission issued "the guiding principles for the clinical application of new antitumor drugs" in 2020. The principle pointed out that under special circumstances such as the absence of better treatment, medical institutions should manage the usage of drugs that are not clearly defined in the instructions but have evidence-based data. Based on the latest research progress in breast cancer, the consensus writing expert group collated published reports, international academic conferences, conducted analysis, discussion and summary, collected data on the use of small molecule anti-vascular targeting drugs for advanced breast cancer, and formulated "expert consensus on the application of small molecule anti-angiogenic drugs in the treatment of advanced breast cancer" . For clinicians' reference only.乳腺癌是全世界发病率最高的恶性肿瘤，晚期乳腺癌患者5年生存率仅为20%。晚期乳腺癌的治疗以化疗、内分泌治疗和靶向治疗为主，但经多线治疗后患者容易对药物产生耐药，特别是三阴性晚期乳腺癌。肿瘤血管生成学说认为阻断血管生成可以抑制肿瘤生长和迁移。抗血管生成类药物主要包括靶向血管内皮生长因子(VEGF)或血管内皮生长因子受体(VEGFR)的生物大分子药物以及小分子VEGFR抑制剂。血管生成在乳腺癌生长和转移扩散中发挥关键作用，因此，抗血管生成治疗在晚期乳腺癌中也具有临床潜力。中华人民共和国国家卫生健康委员会于2020年颁布的《新型抗肿瘤药物临床应用指导原则》指出，在尚无更好治疗手段等特殊情况下，医疗机构应当对说明书中未明确、但具有循证医学证据的药品用法进行管理。共识撰写专家组根据国内外乳腺癌研究进展，整理国内外已发表的文献及国际学术大会报道，进行分析、讨论和总结，对小分子抗血管靶向药用于晚期乳腺癌治疗的数据进行汇总，制定了小分子抗血管生成药物治疗晚期乳腺癌超说明书用药专家共识，仅供临床医师参考。.