Fundação Antônio Prudente, Hospital do Câncer A. C. Camargo, Rua Prof Antônio Prudente, Liberdade, São Paulo, SP, 01509-900, Brazil.
Med Oncol. 2011 Jun;28(2):416-9. doi: 10.1007/s12032-010-9469-4. Epub 2010 Mar 20.
Although the incidence of breast cancer has been declining in recent years, the disease is still one of the leading causes of cancer deaths in women. Recently, breast cancer has been treated with innovative approaches that use hormone-sensitive therapies. This is because in at least one-third of breast cancers, estrogens mediated via the estrogen receptor pathway act as endocrine growth factors. Fulvestrant has been studied as both first- and second-line therapy for locally advanced and metastatic breast cancer, but few studies have shown its effect as third-line therapy alone. To observe the disease time to progression (TTP) obtained with fulvestrant when used on metastatic breast cancer as first-, second-, and also third-line therapy. We also aimed to correlate the TTP obtained with fulvestrant with hormone receptor, HER2 expression, and metastatic site. This was a cohort study that retrospectively examined medical records of 73 postmenopausal women with advanced breast cancer who were treated with fulvestrant (250 mg/month i.m. injection) and followed at the Department of Medical Oncology at Hospital do Cancer A. C. Camargo in São Paulo, Brazil from August 2003 to December 2006. The median TTP with fulvestrant was about 11 months. When used as the first-line therapy, TTP was about 13 months; when used as second-line, TTP was about 6 months; and when used as third-line, it was about 12 months. No statistically significant difference was observed regarding the therapy line. In patients with positive ER tumors, TTP was 11 months. No significant difference in TTP was observed in negative ER tumors (TTP = 10 months). In patients with positive PgR tumors, TTP was 13 months and for negative PgR, TTP was 6 months (P = 0.008). According to the HER2 status, the TTP was 5 months for HER2+ and 10 months for HER2-. Our findings indicate that fulvestrant is an effective alternative for treatment of metastatic breast cancer.
虽然近年来乳腺癌的发病率有所下降，但它仍是女性癌症死亡的主要原因之一。最近，乳腺癌的治疗采用了创新性的方法，这些方法使用了激素敏感疗法。这是因为在至少三分之一的乳腺癌中，雌激素通过雌激素受体途径作为内分泌生长因子发挥作用。氟维司群已被研究用于局部晚期和转移性乳腺癌的一线和二线治疗，但很少有研究表明其作为三线治疗的单独效果。观察氟维司群在转移性乳腺癌中作为一线、二线和三线治疗的疾病进展时间（TTP）。我们还旨在将氟维司群获得的 TTP 与激素受体、HER2 表达和转移部位相关联。这是一项回顾性队列研究，检查了 2003 年 8 月至 2006 年 12 月在巴西圣保罗 A.C.Camargo 癌症医院医学肿瘤学系接受氟维司群（每月 250mg，肌内注射）治疗的 73 例绝经后晚期乳腺癌女性的病历。氟维司群的中位 TTP 约为 11 个月。作为一线治疗时，TTP 约为 13 个月；作为二线治疗时，TTP 约为 6 个月；作为三线治疗时，TTP 约为 12 个月。在治疗线方面未观察到统计学上的显著差异。在 ER 阳性肿瘤患者中，TTP 为 11 个月。在 ER 阴性肿瘤患者中，TTP 无显著差异（TTP=10 个月）。在 PgR 阳性肿瘤患者中，TTP 为 13 个月，在 PgR 阴性肿瘤患者中，TTP 为 6 个月（P=0.008）。根据 HER2 状态，HER2+的 TTP 为 5 个月，HER2-的 TTP 为 10 个月。我们的研究结果表明，氟维司群是治疗转移性乳腺癌的有效替代药物。
