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赫赛汀与紫杉烷类药物的相互作用。

Interaction between Herceptin and taxanes.

作者信息

Diéras V, Beuzeboc P, Laurence V, Pierga J Y, Pouillart P

机构信息

Department of Medical Oncology, Institut Curie, Service de Medecine Oncologique, Paris, France.

出版信息

Oncology. 2001;61 Suppl 2:43-9. doi: 10.1159/000055401.

Abstract

The taxanes and Herceptin have been shown to possess significant clinical activity in metastatic breast cancer. Preclinical testing of taxane/Herceptin combinations demonstrated additive and synergistic interactions with paclitaxel and docetaxel, respectively. In a pivotal clinical trial, combination of paclitaxel (3-weekly) and Herceptin was associated with an increased response rate compared with paclitaxel monotherapy (41% vs. 17%; p = 0.001). The combination therapy also significantly improved time to disease progression (6.9 vs. 2.7 months; p < 0.05). In a phase II study of weekly paclitaxel plus Herceptin in patients with normal or increased tumor HER2 levels, a response was observed in 60% of patients and the regimen was well tolerated. Responses were more frequent in patients with HER2-overexpressing tumors (83% vs. 45%). Preliminary results from a phase II study of Herceptin plus docetaxel in patients with HER2-overexpressing tumors indicate significant activity, with a response observed in 7 (44%) of 16 evaluable patients. The preliminary results of a trial of weekly docetaxel and Herceptin demonstrate a response rate of 54% in 13 evaluable patients. Additional European trials of Hercep- tin/taxane combinations as first- and second-line and adjuvant therapy are ongoing. The results of the studies to date indicate that regimens combining Herceptin with 3-weekly and weekly taxane are effective and well tolerated.

摘要

紫杉烷类药物和赫赛汀已被证明在转移性乳腺癌中具有显著的临床活性。紫杉烷/赫赛汀联合用药的临床前试验分别显示与紫杉醇和多西他赛存在相加和协同相互作用。在一项关键临床试验中,与紫杉醇单药治疗相比,紫杉醇(每3周一次)联合赫赛汀的联合用药方案使缓解率提高(41% 对17%;p = 0.001)。联合治疗还显著改善了疾病进展时间(6.9个月对2.7个月;p < 0.05)。在一项针对肿瘤HER2水平正常或升高的患者的II期研究中,每周一次紫杉醇联合赫赛汀治疗,60%的患者出现缓解,且该方案耐受性良好。HER2过表达肿瘤患者的缓解更为常见(83% 对45%)。一项针对HER2过表达肿瘤患者的赫赛汀联合多西他赛的II期研究的初步结果显示有显著活性,16例可评估患者中有7例(44%)出现缓解。一项每周一次多西他赛和赫赛汀试验的初步结果显示,13例可评估患者的缓解率为54%。欧洲正在进行更多关于赫赛汀/紫杉烷联合用药作为一线、二线和辅助治疗的试验。迄今为止的研究结果表明,赫赛汀与每3周一次和每周一次紫杉烷联合的方案有效且耐受性良好。

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