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Oncologist. 2010;15(8):810-8. doi: 10.1634/theoncologist.2010-0081. Epub 2010 Aug 3.
PURPOSE: Angiogenesis is an important hallmark of breast cancer growth and progression. Pazopanib, an oral small molecule inhibitor of vascular endothelial growth factor receptor, platelet-derived growth factor receptor, and KIT, has activity across a range of solid tumors. We evaluated the activity of single-agent pazopanib in recurrent or metastatic breast cancer (MBC). PATIENTS AND METHODS: Patients with recurrent breast cancer or MBC, treated with up to two prior lines of chemotherapy, were eligible to receive pazopanib, 800 mg daily until progression. The primary endpoint was the objective response rate as measured by Response Evaluation Criteria in Solid Tumors. Secondary endpoints included time to progression, the stable disease rate, and toxicity. Using a two-stage design, confirmed response in three of 18 patients was required to proceed to stage 2. RESULTS: Twenty evaluable patients were treated, with a median age of 56 years; 70% were estrogen receptor positive, all were human epidermal growth factor receptor 2 negative. The majority had one or two prior lines of chemotherapy. One patient (5%) had a partial response, 11 (55%) had stable disease (SD) [four (20%) with SD > or = 6 months], and seven (35%) had progressive disease as their best response. One (5%) was not evaluable. The median time to progression was 5.3 months. Pazopanib did not cause significant severe toxicity aside from grade 3-4 transaminitis, hypertension, and neutropenia in three patients each (14% each) and grade 3 gastrointestinal hemorrhage in one patient (5%). CONCLUSION: Pazopanib provides disease stability in advanced breast cancer. The activity seen is comparable with that of other antiangiogenic agents in this setting. Pazopanib may be of interest for future studies in breast cancer, including in combination with other systemic agents.
目的:血管生成是乳腺癌生长和进展的一个重要标志。帕唑帕尼是一种口服小分子血管内皮生长因子受体、血小板衍生生长因子受体和 KIT 的抑制剂,在多种实体肿瘤中均有活性。我们评估了单药帕唑帕尼在复发性或转移性乳腺癌(MBC)中的活性。
患者和方法:接受过最多两线化疗的复发性乳腺癌或 MBC 患者有资格接受帕唑帕尼治疗,每日 800mg,直至疾病进展。主要终点是根据实体瘤反应评价标准测量的客观缓解率。次要终点包括无进展生存期、疾病稳定率和毒性。采用两阶段设计,需要在 18 例患者中有 3 例确认缓解才能进入第二阶段。
结果:20 例可评估患者接受了治疗,中位年龄为 56 岁;70%的患者雌激素受体阳性,所有患者人表皮生长因子受体 2 阴性。大多数患者接受过一次或两次化疗。1 例患者(5%)有部分缓解,11 例(55%)疾病稳定(SD)[4 例(20%)SD ≥ 6 个月],7 例(35%)疾病进展为最佳缓解。1 例(5%)无法评估。中位无进展生存期为 5.3 个月。帕唑帕尼除了导致 3 例(14%)患者出现 3-4 级氨基转移酶升高、高血压和中性粒细胞减少症以及 1 例(5%)患者出现 3 级胃肠道出血外,没有引起明显的严重毒性。
结论:帕唑帕尼可使晚期乳腺癌保持稳定。在这种情况下,观察到的活性与其他抗血管生成药物相似。帕唑帕尼可能是未来乳腺癌研究的一个选择,包括与其他全身药物联合使用。
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