Ishida Takanori, Kiba Takayoshi, Takeda Motohiro, Matsuyama Kotone, Teramukai Satoshi, Ishiwata Ryota, Masuda Norikazu, Takatsuka Yuichi, Noguchi Shinzaburo, Ishioka Chikashi, Fukushima Masanori, Ohuchi Noriaki
Department of Surgical Oncology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Cancer Chemother Pharmacol. 2009 Jul;64(2):361-9. doi: 10.1007/s00280-008-0882-8. Epub 2008 Dec 12.
The purpose of this study was to investigate the activity of capecitabine and trastuzumab in patients with HER2-overexpressing metastatic breast cancer resistant to both anthracyclines and taxanes.
From June 2003 and May 2006, 40 female patients with measurable or assessable metastatic breast cancer were enrolled and data from 38 patients were reviewed extramurally and analyzed. Patients were treated with weekly trastuzumab given at a dose of 2 mg/kg/day over 90 min (4 mg/kg/day on the first infusion) and capecitabine given at a dose 1,657 mg/m(2)/day during 21 days with a subsequent pause of 7 days. This cycle was repeated every 28 days. The primary endpoint was overall survival and secondary endpoints were progression-free survival and response rate.
A median of 4.5 cycles (range 1-9 cycles) were delivered. The median age was 53 (range 30-69 years). Median overall survival and progression-free survival was 22.3 and 4.1 months, respectively. Survival rate at 1 and 2 year was 81.6 and 47.4%, respectively. Response rate was 18.4% (95% CI, 7.7-34.3%). All evaluable patients have responded with two CR (5.3%), 5 PR (13.2%), 20 SD (52.6%), 8 PD (21.1%) and 3 NE (7.9%). Regarding the hematological toxicities, grade 1/2/3 neutropenia, grade 1/2 anemia, grade 1 thrombocytopenia and grade 1/2 liver dysfunction were also common. No treatment-related death was reported.
The combination of capecitabine and trastuzumab is active and well-tolerated in patients with HER2-overexpressing breast caner resistant to both anthracyclines and taxanes.
本研究旨在调查卡培他滨和曲妥珠单抗在对蒽环类药物和紫杉类药物均耐药的HER2过表达转移性乳腺癌患者中的活性。
从2003年6月至2006年5月,纳入40例患有可测量或可评估转移性乳腺癌的女性患者,并对38例患者的数据进行了外部审查和分析。患者接受每周一次的曲妥珠单抗治疗,剂量为2mg/kg/天,持续90分钟(首次输注时为4mg/kg/天),卡培他滨剂量为1657mg/m²/天,持续21天,随后停药7天。每28天重复此周期。主要终点为总生存期,次要终点为无进展生存期和缓解率。
中位给予4.5个周期(范围1 - 9个周期)。中位年龄为53岁(范围30 - 69岁)。中位总生存期和无进展生存期分别为22.3个月和4.1个月。1年和2年生存率分别为81.6%和47.4%。缓解率为18.4%(95%CI,7.7 - 34.3%)。所有可评估患者的反应为2例完全缓解(5.3%)、5例部分缓解(13.2%)、20例疾病稳定(52.6%)、8例疾病进展(21.1%)和3例未评估(7.9%)。关于血液学毒性,1/2/3级中性粒细胞减少、1/2级贫血、1级血小板减少和1/2级肝功能障碍也很常见。未报告与治疗相关的死亡。
卡培他滨和曲妥珠单抗联合用药在对蒽环类药物和紫杉类药物均耐药的HER2过表达乳腺癌患者中具有活性且耐受性良好。