Gómez-Bernal Amalia, Cruz Juan Jesús, García-Palomo Andrés, Arizcun Alberto, Pujol Eduardo, Diz Pilar, Martín Germán, Fonseca Emilio, Sánchez Pedro, Rodríguez César, del Barco Elvira, López Yolanda
Hospital Universitario de Salamanca, Salamanca, Spain.
Am J Clin Oncol. 2003 Apr;26(2):127-31. doi: 10.1097/00000421-200304000-00005.
The aim of this study was to determine the efficacy and toxicity of a biweekly combination of docetaxel and vinorelbine in patients with metastatic breast cancer (MBC) previously treated with anthracyclines. Eligible patients (n = 49) with MBC received vinorelbine, 25 mg/m2, followed by docetaxel, 60 mg/m2. Cycles were repeated every 14 days for a total of 8 planned cycles. Response rate was evaluated every 4 cycles. All 49 patients were evaluable for safety and 44 for efficacy. Vinorelbine plus docetaxel resulted in an overall response rate of 45% (CI 95%: 31-60) with 2 (4%) complete responses and 18 (41%) partial responses. Patients with visceral metastasis achieved a lower response rate than those without (33% versus 60%, p = 0.044). Time to progression was 11.0 months (CI 95%: 8.6-13.5), and median overall survival was 12.7 months (CI 95%: 9.0-16.4). The most common grade III to IV hematologic adverse events was neutropenia (65% of patients). Febrile neutropenia was observed in 9 cycles (3%) and in 7 patients (14%). Grade III to IV nonhematologic toxicity was rare. Biweekly combination of docetaxel and vinorelbine is an effective and well-tolerated regimen in anthracycline-resistant MBC.
本研究的目的是确定多西他赛和长春瑞滨每两周联合使用对先前接受过蒽环类药物治疗的转移性乳腺癌(MBC)患者的疗效和毒性。符合条件的49例MBC患者接受长春瑞滨25mg/m²,随后接受多西他赛60mg/m²。每14天重复一个周期,共计划进行8个周期。每4个周期评估一次缓解率。所有49例患者均可进行安全性评估,44例可进行疗效评估。长春瑞滨加多西他赛的总缓解率为45%(95%CI:31-60),其中2例(4%)完全缓解,18例(41%)部分缓解。内脏转移患者的缓解率低于无内脏转移患者(33%对60%,p=0.044)。疾病进展时间为11.0个月(95%CI:8.6-13.5),中位总生存期为12.7个月(95%CI:9.0-16.4)。最常见的Ⅲ至Ⅳ级血液学不良事件是中性粒细胞减少(65%的患者)。9个周期(3%)和7例患者(14%)观察到发热性中性粒细胞减少。Ⅲ至Ⅳ级非血液学毒性罕见。多西他赛和长春瑞滨每两周联合使用是一种治疗蒽环类耐药MBC的有效且耐受性良好的方案。