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吉西他滨联合紫杉醇治疗转移性乳腺癌且既往接受过蒽环类药物治疗患者的II期研究。

A phase II study of gemcitabine plus paclitaxel in patients with metastatic breast cancer and prior anthracycline treatment.

作者信息

Xu Binghe, Shen Zhenzhou, Jiang Zefei, Guan Zhongzhen, Zhang Xiaoqing

机构信息

Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Asia Pac J Clin Oncol. 2010 Dec;6(4):320-9. doi: 10.1111/j.1743-7563.2010.01323.x. Epub 2010 Oct 26.

Abstract

AIM

To investigate the efficacy and safety of gemcitabine-paclitaxel in Chinese patients with metastatic breast cancer following anthracycline failure in a multicenter, open-label, single-arm, phase II clinical trial.

METHODS

Chinese female patients with unresectable, locally recurrent or metastatic breast cancer who had relapsed after neo-adjuvant anthracycline-based chemotherapy were included. All patients had measurable disease and an Eastern Cooperative Oncology Group performance status of 0 or 1 at baseline. Gemcitabine (1250 mg/m(2) )-paclitaxel (175 mg/m(2) ) was administered on a 3-weekly schedule until disease progression, and patients were followed up for 12 months (post-enrollment). The primary end point was objective response rate; secondary end points included duration of response, progression-free survival and overall survival.

RESULTS

Overall 60 patients were enrolled. Their mean age was 46.9 (SD ± 9.0) years and 90% of patients had metastatic disease. All patients had previously received chemotherapy. A total of 48 patients (80%) completed the 12-month follow up, and 40 patients (67%) completed at least six cycles of study therapy. The objective response rate (complete response + partial response) was 50% (95% CI: 36.6-63.4). Median duration of response was 5.6 months (95% CI: 4.4-7.6) and median progression-free survival was 7.6 months (95% CI: 5.8-8.8). Overall survival at 12 months was 87% (95% CI: 77.9-95.2). Laboratory toxicities were primarily hematologic, including Grade 3 and 4 neutropenia (n = 27 [45%]) and leukopenia (n = 18 [30%]). Eight patient deaths (13%) were not treatment-related.

CONCLUSION

Gemcitabine-paclitaxel combination therapy is an active and well-tolerated chemotherapy regimen, with expected and manageable toxicity in Chinese patients with metastatic breast cancer.

摘要

目的

在一项多中心、开放标签、单臂、II期临床试验中,研究吉西他滨联合紫杉醇治疗蒽环类药物治疗失败后的中国转移性乳腺癌患者的疗效和安全性。

方法

纳入新辅助蒽环类化疗后复发的不可切除、局部复发或转移性乳腺癌中国女性患者。所有患者均有可测量病灶,基线时东部肿瘤协作组体能状态为0或1。每3周给予吉西他滨(1250mg/m²)联合紫杉醇(175mg/m²),直至疾病进展,患者随访12个月(入组后)。主要终点为客观缓解率;次要终点包括缓解持续时间、无进展生存期和总生存期。

结果

共纳入60例患者。她们的平均年龄为46.9(标准差±9.0)岁,90%的患者有转移性疾病。所有患者既往均接受过化疗。共有48例患者(80%)完成了12个月的随访,40例患者(67%)完成了至少六个周期的研究治疗。客观缓解率(完全缓解+部分缓解)为50%(95%CI:36.6-63.4)。中位缓解持续时间为5.6个月(95%CI:4.4-7.6),中位无进展生存期为7.6个月(95%CI:5.8-8.8)。12个月时的总生存率为87%(95%CI:77.9-95.2)。实验室毒性主要为血液学毒性,包括3级和4级中性粒细胞减少(n=27[45%])和白细胞减少(n=18[30%])。8例患者死亡(13%)与治疗无关。

结论

吉西他滨联合紫杉醇的联合治疗是一种有效的且耐受性良好的化疗方案,对于中国转移性乳腺癌患者具有预期的且可控制的毒性。

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