Department of Medical Oncology, CRLC Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier Cedex 5, France.
Breast Cancer. 2012 Jan;19(1):16-22. doi: 10.1007/s12282-010-0240-7. Epub 2010 Nov 19.
Since 2004, metastatic breast cancer patients pretreated with anthracyclines, taxanes, and capecitabine have been treated in our institution with a combination of mitomycin C, methotrexate, and VP-16 (VMM). We report in this study a retrospective analysis of the activity and safety of the VMM combination.
Patients were treated with a combination of VP-16 (100 mg/m2 on day 1), mitomycin C (MMC, 10 mg/m2 on day 1), and methotrexate (MTX, 12.5 mg/m2 twice a day on day 2 and 3) in a 21-day cycle.
Seventy-five patients were treated. Median age was 48 years. A total of 256 cycles were administered. Median relative dose intensities were 0.87, 0.87, and 0.95 for VP-16, MMC, and MTX, respectively. Objective response rate was 31%, with a clinical benefit rate of 47%. Median response duration was 5.8 months. Median disease stabilization duration was 9.1 months. Median progression-free survival (PFS) was 4.2 months with a 14% 1-year PFS rate. Median overall survival (OS) was 6.2 months, with a 25% 1-year OS rate. Myelosuppression was the most common toxicity. The most commonly reported extra-hematological adverse event (AE) was fatigue. Emesis and alopecia were rarely reported.
This combination appears to be effective and well tolerated in this heavily pretreated metastatic breast cancer population.
自 2004 年以来，在我们机构中，接受过蒽环类药物、紫杉烷类药物和卡培他滨预处理的转移性乳腺癌患者采用了米托蒽醌、甲氨蝶呤和 VP-16（VMM）联合治疗。在此研究中，我们报告了 VMM 联合治疗的回顾性分析结果。
患者采用 VP-16（第 1 天 100mg/m2）、米托蒽醌（MMC，第 1 天 10mg/m2）和甲氨蝶呤（MTX，第 2 天和第 3 天每天两次 12.5mg/m2）联合方案治疗，每 21 天为一个周期。
75 例患者接受了治疗。中位年龄为 48 岁。共给予 256 个周期的治疗。VP-16、MMC 和 MTX 的中位相对剂量强度分别为 0.87、0.87 和 0.95。客观缓解率为 31%，临床获益率为 47%。中位缓解持续时间为 5.8 个月。中位疾病稳定持续时间为 9.1 个月。中位无进展生存期（PFS）为 4.2 个月，1 年 PFS 率为 14%。中位总生存期（OS）为 6.2 个月，1 年 OS 率为 25%。骨髓抑制是最常见的毒性反应。最常见的非血液学不良反应（AE）是疲劳。呕吐和脱发很少见。
在这种预处理的转移性乳腺癌患者人群中，该联合方案似乎具有疗效，且耐受性良好。
