Hsu Hung-Chih, Chang Hsien-Kun, Lin Yung-Chang, Hseu Sheu, Chen Jen-Shi, Yang Tsai-Shen, Wang Hung-Ming, Shen Wen-Chi
Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
Chang Gung Med J. 2009 Jan-Feb;32(1):33-41.
A combination of taxanes and cisplatin have shown modest activity as second-line chemotherapy in breast cancer patients who have been exposed to anthracyclines. The purpose of this study was to retrospectively assess whether HER2 is associated with clinical sensitivity or with prognostic significance in breast cancer patient groups who had received chemotherapy with taxanes and cisplatin.
Patients were treated either with docetaxel 60 mg/m square or paclitaxel 175 mg/m square in combination with cisplatin 50 mg/m/every 3 weeks. The tumor specimens were checked for estrogen receptor (ER), progestrone receptor (PR), and HER2 status by immunohistochemical stain. Prognostic factors such as performance status, status of metastases, history of prior anthracycline response, and biomarkers such as ER and HER2 were analyzed.
Ninety patients were eligible for HER2 assessment. Only eighty-five patients were eligible for response assessment. The overall response rate to chemotherapy with the taxanes/cisplatin regimen was 52%. In patients who were HER2-positive, the response rate was 62% and in HER2-negative patients, it was 46%, p= 0.17. Univariate analysis showed no prognostic factors were significant in predicting a response to chemotherapy. In addition, it appeared that there was no difference in time to progression and overall survival based on HER2 status.
Our results indicated that HER2 status is independent of a response to a taxanes/cisplatin combination and is also not a prognostic factor for survival.
对于接受过蒽环类药物治疗的乳腺癌患者,紫杉烷类与顺铂联合作为二线化疗已显示出一定活性。本研究的目的是回顾性评估在接受紫杉烷类和顺铂化疗的乳腺癌患者群体中,HER2是否与临床敏感性或预后意义相关。
患者接受多西他赛60mg/m²或紫杉醇175mg/m²联合顺铂50mg/m²,每3周一次的治疗。通过免疫组化染色检查肿瘤标本的雌激素受体(ER)、孕激素受体(PR)和HER2状态。分析预后因素,如体能状态、转移状态、既往蒽环类药物反应史,以及生物标志物如ER和HER2。
90例患者符合HER2评估标准。仅85例患者符合反应评估标准。紫杉烷类/顺铂方案化疗的总反应率为52%。HER2阳性患者的反应率为62%,HER2阴性患者为46%,p = 0.17。单因素分析显示,无预后因素在预测化疗反应方面具有显著性。此外,基于HER2状态,进展时间和总生存期似乎无差异。
我们的结果表明,HER2状态与紫杉烷类/顺铂联合治疗的反应无关,也不是生存的预后因素。