Brodowicz T, Kostler W J, Möslinger R, Tomek S, Vaclavik I, Herscovici V, Wiltschke C, Steger G G, Wein W, Seifert M, Kubista E, Zielinski C C
Clinical Division of Oncology, Department of Medicine I, University Hospital, Vienna, Austria.
Breast. 2000 Dec;9(6):338-42. doi: 10.1054/brst.2000.0170.
In the present study, 25 patients with breast cancer pretreated with one or two anthracycline-based regimens for visceral metastases were enrolled. Patients were treated with gemcitabine 1250 mg/m2 on days 1, 8 and 15, q28d. Nine patients received gemcitabine as second-line treatment, whereas 16 patients received gemcitabine as third-line cytotoxic treatment, respectively. In the second-line setting, two (22%) patients gained PR (RR 22%) and four (44%) patients experienced SD (P=0.2), respectively. In the third-line-setting, one (6%) patient gained CR, one patient PR (6%) and four patients (25%) SD, respectively, resulting in a response rate (RR) of 12%. In the second-line-setting, median time to progression was 5.1 +/- 4.0 months (range: 1.6-13.9) versus 3.5-2.5 months (range: 1.3-10.4) in the third-line-setting. Median overall survival was 12.6 +/- 9.1 months (range: 3.9-30.8) versus 7.5 +/- 6.7 months (range: 2.0-26.0), respectively. Overall, no patient experienced treatment limiting toxicities. We conclude from the present study that gemcitabine induced an overall RR of 16% following prior treatment with anthracyclines. However, median time to progression and median overall survival were limited. In the search for efficacious treatment of patients with metastatic breast cancer, gemcitabine constitutes a valid tool in anthracycline-resistant disease and thus might represent a valuable option for combination chemotherapy in controlled trials in this condition.
在本研究中，纳入了25例因内脏转移而接受过一或两种基于蒽环类药物方案预处理的乳腺癌患者。患者在第1、8和15天接受吉西他滨治疗，剂量为1250 mg/m²，每28天重复一次。9例患者接受吉西他滨作为二线治疗，而16例患者分别接受吉西他滨作为三线细胞毒性治疗。在二线治疗中，分别有2例（22%）患者获得部分缓解（RR 22%），4例（44%）患者疾病稳定（P=0.2）。在三线治疗中，分别有1例（6%）患者获得完全缓解，1例患者部分缓解（6%），4例患者（25%）疾病稳定，缓解率（RR）为12%。在二线治疗中，疾病进展的中位时间为5.1±4.0个月（范围：1.6 - 13.9个月），而在三线治疗中为3.5 - 2.5个月（范围：1.3 - 10.4个月）。总生存中位数分别为12.6±9.1个月（范围：3.9 - 30.8个月）和7.5±6.7个月（范围：2.0 - 26.0个月）。总体而言，没有患者经历治疗限制性毒性。我们从本研究得出结论，在先前接受蒽环类药物治疗后，吉西他滨诱导的总体缓解率为16%。然而，疾病进展的中位时间和总生存中位数有限。在寻找转移性乳腺癌患者的有效治疗方法时，吉西他滨是蒽环类耐药疾病的一种有效工具，因此可能是这种情况下对照试验中联合化疗的一个有价值的选择。
