Levine M
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Clin Breast Cancer. 2000 Sep;1 Suppl 1:S62-7. doi: 10.3816/cbc.2000.s.012.
Epirubicin, a member of the anthracycline family of chemotherapeutic agents, has been widely used throughout the world both as adjuvant therapy in early breast cancer and in metastatic breast cancer. Clinical trials with epirubicin have examined the importance of a dose-response relationship, therapeutic dose, and optimum duration of chemotherapy. In addition, pharmacokinetic studies have provided data on ideal combinations with other agents. Epirubicin-containing regimens are considered to be superior to those containing cyclophosphamide, methotrexate, and fluorouracil (CMF) and are also used in patients with locally advanced stage IIIA/IIIB breast cancer. Combinations with other chemotherapeutic agents (eg, epirubicin plus a taxane, sequential or combined use of these agents) are being evaluated in ongoing clinical trials. Moreover, recent studies have suggested that biologic markers, such as tumor HER2/neu overexpression, predict responses to dose-intensive anthracycline chemotherapy, and combinations with nonchemotherapeutic regimens (eg, trastuzumab) may provide additional benefits, but such strategies require further evaluation.
表柔比星是化疗药物蒽环类家族的一员，在全世界范围内广泛用于早期乳腺癌的辅助治疗及转移性乳腺癌的治疗。有关表柔比星的临床试验研究了剂量反应关系、治疗剂量及化疗的最佳疗程的重要性。此外，药代动力学研究提供了与其他药物理想联合的数据。含表柔比星的治疗方案被认为优于含环磷酰胺、甲氨蝶呤和氟尿嘧啶（CMF）的方案，也用于局部晚期IIIA/IIIB期乳腺癌患者。与其他化疗药物的联合方案（如，表柔比星加紫杉烷，这些药物的序贯或联合使用）正在进行的临床试验中进行评估。此外，最近的研究表明，生物标志物，如肿瘤HER2/neu过表达，可预测对剂量密集型蒽环类化疗的反应，与非化疗方案（如曲妥珠单抗）联合可能会带来额外益处，但此类策略需要进一步评估。
