Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Cancer Res Treat. 2008 Jun;40(2):81-6. doi: 10.4143/crt.2008.40.2.81. Epub 2008 Jun 30.
Anthracycline and taxanes are effective agents in advanced breast cancer and prolong survival times. Some patients achieve prolongation of life with capecitabine, gemcitabine, or vinorelbine, even after failure of both anthracycline and taxanes. We analyzed the efficacy and toxicity of gemcitabine and vinorelbine combination chemotherapy in anthracycline- and taxane-pretreated advanced breast cancer.
The medical records of anthracycline- and taxane-pretreated metastatic breast cancer patients who received gemcitabine and vinorelbine combination chemotherapy at the Seoul National University Hospital were reviewed. Gemcitabine (1,000 mg/m(2)) and vinorelbine (25 mg/m(2)) were administered intravenously on days 1 and 8 every 3 weeks.
Between 2000 and 2006, 57 patients were eligible (median age, 45 years), and the median number of previous chemotherapy regimens was 3 (range, 1 approximately 5). The overall response rate was 30% (95% CI, 18.1 approximately 41.9), and the disease control rate was 46% (PR, 30%; SD, 16%). The median duration of follow-up was 33.4 months, the median time-to-progression (TTP) was 3.9 months, and the median overall survival was 10.8 months. None of the patients with patients with anthracycline and taxane primary resistance showed a response and the median TTP for these patients was significantly shorter than that of other patients (1.9 vs. 4.4 months; p=0.018). Although the efficacy was unsatisfactory in patients with both anthracycline and taxane primary resistance, gemcitabine and vinorelbine combination chemotherapy showed comparable efficacy in anthracycline- and/or taxane-sensitive patients and the patients with secondary resistance, even after failure of second-line therapy. Grade 3/4 hematologic toxicities included neutropenia (18.1%) and febrile neutropenia (0.3%), and non-hematologic toxicities were tolerable.
Gemcitabine and vinorelbine combination chemotherapy in anthracycline- and taxane-pretreated advanced breast cancer was effective and tolerable.
阿霉素和紫杉烷类药物是晚期乳腺癌的有效药物，可延长生存时间。有些患者即使在阿霉素和紫杉烷类药物治疗失败后，仍能通过卡培他滨、吉西他滨或长春瑞滨延长生命。我们分析了吉西他滨和长春瑞滨联合化疗在阿霉素和紫杉烷类预处理的晚期乳腺癌中的疗效和毒性。
回顾了在首尔国立大学医院接受吉西他滨和长春瑞滨联合化疗的阿霉素和紫杉烷预处理转移性乳腺癌患者的病历。吉西他滨（1000mg/m²）和长春瑞滨（25mg/m²）于每 3 周的第 1 天和第 8 天静脉给药。
2000 年至 2006 年间，57 例患者符合条件（中位年龄 45 岁），中位化疗方案数为 3 个（范围 1-5 个）。总缓解率为 30%（95%CI，18.1-41.9%），疾病控制率为 46%（PR，30%；SD，16%）。中位随访时间为 33.4 个月，中位无进展生存期（TTP）为 3.9 个月，中位总生存期为 10.8 个月。无原发耐药患者有缓解，这些患者的中位 TTP 明显短于其他患者（1.9 个月 vs. 4.4 个月；p=0.018）。尽管在原发耐药患者中疗效不佳，但吉西他滨和长春瑞滨联合化疗在阿霉素和/或紫杉烷类敏感患者和继发耐药患者中显示出相当的疗效，即使在二线治疗失败后也是如此。3/4 级血液学毒性包括中性粒细胞减少症（18.1%）和发热性中性粒细胞减少症（0.3%），非血液学毒性可耐受。
阿霉素和紫杉烷类预处理的晚期乳腺癌中吉西他滨和长春瑞滨联合化疗是有效且耐受良好的。
