Uhm Ji Eun, Park Yeon Hee, Yi Seong Yoon, Cho Eun Yoon, Choi Yoon La, Lee Su Jin, Park Min Jae, Lee Se-Hoon, Jun Hyun Jung, Ahn Jin Seok, Kang Won Ki, Park Keunchil, Im Young-Hyuck
Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Int J Cancer. 2009 Mar 15;124(6):1457-62. doi: 10.1002/ijc.24090.
The aim of this study was to evaluate the role of platinum-containing chemotherapy for metastatic triple-negative breast cancer (TNBC) patients in terms of the response rate (RR) and progression-free survival. A second aim was to characterize the clinical behavior at the time of relapse of TNBC. We retrospectively analyzed the clinical outcomes of patients with metastatic breast cancer who received taxane-platinum chemotherapy as the first- or second-line treatment, focusing on the TN phenotype. In total, 257 patients with metastatic breast cancer received platinum-containing chemotherapy at Samsung Medical Center from 1999 to 2006. Of these patients, 106 patients with available data on estrogen (ER), progesterone (PgR) and human epidermal growth factor receptor-2 (HER2) receptor status received taxane-platinum regimen as the first- or second-line treatment. The overall RR of patients with TNBC was 39%. This rate did not differ significantly from those of patients with other phenotypes. The time to death after chemotherapy (19 vs. 50 months, p = 0.037) and overall survival (OS) (21 vs. 56 months, p = 0.030) differed significantly between patients with TNBC and non-TNBC. TNBC showed a unique locoregional infiltration pattern at relapse, which might reflect its aggressive clinical behavior. Despite the similar response to platinum-containing chemotherapy, patients with TNBC had a shorter OS than patients with non-TNBC. The implication of TN phenotype as poor prognostic factor is uncertain, because it needs to be defined whether poor outcome is related to the rapid growing characteristics of tumor itself or the resistance to drug therapy. Further prospective studies are warranted.
本研究的目的是从缓解率（RR）和无进展生存期方面评估含铂化疗对转移性三阴性乳腺癌（TNBC）患者的作用。第二个目的是描述TNBC复发时的临床行为特征。我们回顾性分析了接受紫杉烷-铂类化疗作为一线或二线治疗的转移性乳腺癌患者的临床结局，重点关注TN表型。1999年至2006年，共有257例转移性乳腺癌患者在三星医疗中心接受了含铂化疗。在这些患者中，106例有雌激素（ER）、孕激素（PgR）和人表皮生长因子受体2（HER2）受体状态可用数据的患者接受了紫杉烷-铂类方案作为一线或二线治疗。TNBC患者的总体RR为39%。该比率与其他表型患者的比率无显著差异。TNBC患者与非TNBC患者化疗后至死亡时间（19个月对50个月，p = 0.037）和总生存期（OS）（21个月对56个月，p = 0.030）有显著差异。TNBC在复发时表现出独特的局部区域浸润模式，这可能反映了其侵袭性的临床行为。尽管对含铂化疗的反应相似，但TNBC患者的OS比非TNBC患者短。TN表型作为不良预后因素的意义尚不确定，因为需要确定不良结局是与肿瘤本身的快速生长特征还是与对药物治疗的耐药性有关。有必要进行进一步的前瞻性研究。
