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[紫杉烷耐药性复发/转移性乳腺癌治疗方案的评估]

[Evaluation of therapeutic regimens for taxane-resistant recurrent/metastatic breast cancer].

作者信息

Kan Norimichi, Yoshikawa Kiyotsugu, Nio Yoshinori, Iguchi Chikage, Kodama Hiroshi

机构信息

Hiei Hospital.

出版信息

Gan To Kagaku Ryoho. 2007 Jul;34(7):1047-52.

Abstract

Taxanes (TX) were administered to 246 of 292 patients with recurrent/metastatic breast cancer (MBC) who were treated in Hiei Hospital between January 2001 and May 2006. Recently, TX has been increasingly prescribed for preoperative treatment and postoperative adjuvant therapy. To improve the prognosis of MBC, regimens effective for TX-resistant cancer patients should be developed. In this study, with respect to hormone receptor (HR) and Her 2/neu (HER 2), we retrospectively investigated whether our series responded to the regimens used after TX resistance was acquired. As post TX-resistance therapy (trastuzumab was combined in HER2-positive patients), 387 treatment regimens were administered to 166 patients. The following regimens achieved a response rate (patients achieving PR or CR/patients who could be evaluated) of 10% or more: combination therapy with TX and capecitabine (11/61, 18%), CPT-11 (10/57, 17.5%), vinorelbine (5/46, 10.9%), MFL-P (continuous treatment with MTX, 5-FU, LV, and CDDP) (12/47, 25.5%), and DMpC (5'-DFUR, MPA, CPA p.o.) (5/16, 31.2%). The latter 2 regimens achieved a high response rate,and some HR (-) and HER 2 (-) patients also responded to these regimens. In HR (+) or HER 2 (+) patients who responded to TX, survival was longer than that of non-responders. However, there was no difference in the treatment responsiveness of post-TX regimens between TX-responders and non-responders, suggesting the survival-prolonging effect of TX.

摘要

2001年1月至2006年5月期间,在比叡医院接受治疗的292例复发/转移性乳腺癌(MBC)患者中,有246例接受了紫杉烷类药物(TX)治疗。最近,TX越来越多地被用于术前治疗和术后辅助治疗。为改善MBC的预后,应开发对TX耐药的癌症患者有效的治疗方案。在本研究中,我们针对激素受体(HR)和人表皮生长因子受体2(Her 2/neu,HER 2),回顾性调查了我们的系列患者在获得TX耐药后对所用治疗方案的反应情况。作为TX耐药后的治疗(HER2阳性患者联合使用曲妥珠单抗),166例患者接受了387种治疗方案。以下治疗方案的缓解率(达到部分缓解或完全缓解的患者数/可评估的患者数)达到或超过10%:TX与卡培他滨联合治疗(11/61,18%)、伊立替康(10/57,17.5%)、长春瑞滨(5/46,10.9%)、MFL-P(甲氨蝶呤、5-氟尿嘧啶、亚叶酸钙和顺铂持续治疗)(12/47,25.5%)以及DMpC(口服5'-去氧氟尿苷、甲羟孕酮、环磷酰胺)(5/16,31.2%)。后两种治疗方案缓解率较高,一些HR(-)和HER 2(-)患者对这些方案也有反应。在对TX有反应的HR(+)或HER 2(+)患者中,生存期长于无反应者。然而,TX反应者和无反应者之间TX耐药后治疗方案的治疗反应性没有差异,提示TX具有延长生存期的作用。

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