Sommer H, Pröhl-Steimer B, Bajetta E, Haus U, Janni W, Kay A
Universitäts-Frauenklinik Klinikum Innenstadt der LMU München, Germany.
Zentralbl Gynakol. 2001 Oct;123(10):557-61. doi: 10.1055/s-2001-19088.
A randomized, double-blind, placebo-controlled, phase 3 trial comparing SMS 201-995 pa LAR plus tamoxifen versus tamoxifen plus placebo in women with locally recurrent or metastatic breast cancer.
Numerous studies have proved the efficacy of tamoxifen treatment in women with receptor-positive breast cancer. Preclinical and phase I/II-studies showed that tumor control can be improved if Octreotid is added. In this randomized controlled double blind phase III study women received 20 mg tamoxifen daily and either 160 mg Octreoid-Depot i. m. injection once a month or a placebo injection. Until 1998 a total of 263 women were randomized.
The study medication was tolerated well by all patients in the treatment group (n = 133). The most frequent moderate side effects were diarrhea (n = 73), nausea (n = 26), abdominal pain (n = 19), bone pain (n = 24) and fatigue (n = 20). No patient dropped out because of these side effects. Surprisingly, several complete remissions occured. Neither the total survival nor the progression free survival was significantly different between groups. Therefore the study was stopped before the originally planned number of patients (n = 416) had been enrolled.
Octreotid plus tamoxifen does not improve tumor control. It is necessary to define subgroups that might benefit from Octreotid.
一项随机、双盲、安慰剂对照的3期试验,比较SMS 201-995 pa LAR联合他莫昔芬与他莫昔芬联合安慰剂治疗局部复发或转移性乳腺癌女性的疗效。
大量研究已证实他莫昔芬治疗受体阳性乳腺癌女性的疗效。临床前及I/II期研究表明,加用奥曲肽可改善肿瘤控制。在这项随机对照双盲3期研究中,女性患者每日接受20 mg他莫昔芬治疗,每月接受一次160 mg奥曲肽长效注射剂肌肉注射或安慰剂注射。至1998年,共有263名女性被随机分组。
治疗组(n = 133)所有患者对研究药物耐受性良好。最常见的中度副作用为腹泻(n = 73)、恶心(n = 26)、腹痛(n = 19)、骨痛(n = 24)和疲劳(n = 20)。无患者因这些副作用退出研究。令人惊讶的是,出现了几例完全缓解。两组间总生存期和无进展生存期均无显著差异。因此,在达到原计划的患者数量(n = 416)之前,该研究即停止。
奥曲肽联合他莫昔芬不能改善肿瘤控制。有必要确定可能从奥曲肽治疗中获益的亚组。