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铂类化疗在转移性三阴性乳腺癌中的应用:居里研究所经验。

Platinum-based chemotherapy in metastatic triple-negative breast cancer: the Institut Curie experience.

机构信息

Department of Medical Oncology.

Department of Pathology.

出版信息

Ann Oncol. 2011 Apr;22(4):848-856. doi: 10.1093/annonc/mdq461. Epub 2010 Oct 5.

Abstract

BACKGROUND

Although recent experimental data strongly suggest that platinum-based chemotherapy (PBCT) could improve the outcome of triple-negative breast cancer (TNBC), clinical data are lacking. Here, the authors reviewed clinical outcome in patients with metastatic TNBC treated with PBCT.

PATIENTS AND METHODS

We conducted a retrospective analysis of all patients (N=143) treated for metastatic breast cancer with PBCT between 2000 and 2008, at Institut Curie, Paris, France. Ninety-three of them (63.7%) had TNBC. One-hundred twenty patients received cisplatin (CDDP). The main combination used was CDDP-ifosfamide, in 101 patients (70.2%).

RESULTS

Median follow-up was 44 months. For the overall population (N=143), median overall survival (OS) and median progression-free survival (PFS) were 11 and 5 months, respectively. Objective response rate was 33.3% in the TNBC group versus 22% in non-TNBC, P=0.1. We observed no difference of OS, PFS and response duration. Other prognostic factors for poor OS were visceral metastasis sites (P<0.001). One patient died from sepsis during aplasia, 15 had to switch from CDDP to carboplatin because of CDDP-related toxicity.

CONCLUSIONS

Metastatic TNBC patients treated with PBCT tended to have a higher response rate, without a significant improvement of PFS or OS, compared with other subtypes. Toxicity was acceptable. Longer observation and further analysis are warranted.

摘要

背景

尽管最近的实验数据强烈表明铂类化疗(PBCT)可以改善三阴性乳腺癌(TNBC)的预后,但临床数据仍存在不足。在此,作者回顾了接受 PBCT 治疗的转移性 TNBC 患者的临床结局。

患者和方法

我们对法国巴黎居里研究所 2000 年至 2008 年间接受 PBCT 治疗转移性乳腺癌的所有患者(N=143)进行了回顾性分析。其中 93 例(63.7%)为 TNBC。120 例患者接受顺铂(CDDP)治疗。主要联合用药为 CDDP-异环磷酰胺,有 101 例(70.2%)。

结果

中位随访时间为 44 个月。在总体人群(N=143)中,中位总生存期(OS)和中位无进展生存期(PFS)分别为 11 个月和 5 个月。TNBC 组的客观缓解率为 33.3%,而非 TNBC 组为 22%,P=0.1。我们未观察到 OS、PFS 和缓解持续时间的差异。OS 不良的其他预后因素为内脏转移部位(P<0.001)。1 例患者在骨髓抑制期死于败血症,15 例患者因 CDDP 相关毒性而不得不从 CDDP 转为卡铂。

结论

与其他亚型相比,接受 PBCT 治疗的转移性 TNBC 患者的反应率较高,但 PFS 或 OS 无显著改善。毒性可接受。需要进一步观察和分析。

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