Tanabe Masahiko, Ito Yoshinori, Tokudome Nahomi, Sugihara Tsutomu, Miura Hiroyoshi, Takahashi Shunji, Seto Yasuyuki, Iwase Takuji, Hatake Kiyohiko
Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo 135-8550, Japan.
Breast Cancer. 2009;16(4):301-6. doi: 10.1007/s12282-009-0093-0. Epub 2009 Feb 10.
Most patients with breast cancer need anthracycline-based chemotherapy regimens in the adjuvant setting, and an increasing number of them receive taxanes either in this setting or as first-line therapy for metastatic breast cancer (MBC). However, no standard chemotherapy has been fully established for MBC patients pretreated with anthracycline and taxanes.
We retrospectively reviewed the medical records of 48 patients with MBC who had been treated with chemotherapy combining mitomycin C and methotrexate (MMC/MTX), following treatment with anthracycline and taxanes. MMC was given at a dose of 8 mg/m(2) on day 1, and MTX of 60 mg/m(2) on day 1 and day 15. The cycle was repeated every 4 weeks.
There were 11 partial responses (24%). The median time to progression was 4.8 months. The response rate of liver metastasis was 31%. Thrombocytopenia (grade 3) was observed in five patients (10%). Other toxicity was mild and manageable.
Our findings suggest that MMC/MTX could be an effective subsequent treatment for patients whose MBC has been pretreated with anthracycline and taxanes.
大多数乳腺癌患者在辅助治疗中需要基于蒽环类药物的化疗方案，并且越来越多的患者在这种情况下或作为转移性乳腺癌（MBC）的一线治疗接受紫杉烷类药物治疗。然而，对于接受过蒽环类药物和紫杉烷类药物预处理的MBC患者，尚未完全确立标准的化疗方案。
我们回顾性分析了48例MBC患者的病历，这些患者在接受蒽环类药物和紫杉烷类药物治疗后接受了丝裂霉素C和甲氨蝶呤联合化疗（MMC/MTX）。MMC在第1天给予剂量为8mg/m²，MTX在第1天和第15天给予剂量为60mg/m²。每4周重复一个周期。
有11例部分缓解（24%）。中位疾病进展时间为4.8个月。肝转移的缓解率为31%。5例患者（10%）出现血小板减少（3级）。其他毒性较轻且可控。
我们的研究结果表明，MMC/MTX对于MBC已接受蒽环类药物和紫杉烷类药物预处理的患者可能是一种有效的后续治疗方法。
