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单药聚乙二醇脂质体阿霉素(PLD)治疗转移性乳腺癌:一项奥地利观察性试验的结果。

Single-agent pegylated liposomal doxorubicin (PLD) in the treatment of metastatic breast cancer: results of an Austrian observational trial.

机构信息

Department of Internal Medicine V/Hematology-Oncoloy, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria.

出版信息

BMC Cancer. 2011 Aug 24;11:373. doi: 10.1186/1471-2407-11-373.

Abstract

BACKGROUND

In advanced breast cancer, multiple sequential lines of treatments are frequently applied. Pegylated liposomal doxorubicin (PLD) has a favourable toxicity profile and can be used in first or higher lines of therapy. PLD has demonstrated response activity even after prior anthracycline exposure.

METHODS

129 consecutive patients with advanced breast cancer, of whom the majority had been massively pretreated, received PLD as monotherapy within licensed approval, for which efficacy and toxicities were documented.

RESULTS

In a routine therapy setting, PLD was administered in a slightly reduced dose (median, 40 mg/m2 per cycle). Response rate (complete and partial remission) was 26%, and stable disease was observed in 19% of patients. Progression-free (PFS) and overall survival (OS) were 5.8 months and 14.2 months, respectively. There was no difference in terms of response and PFS, no matter if patients had already received anthracycline treatment. Interestingly, PFS proved similar regardless whether PLD was administered as palliative therapy in first, second or third line. Furthermore, PFS and OS were similar in patients with response or stable disease, underscoring the view that disease stabilization is associated with a profound clinical benefit. The most common side effects reported were palmar-plantar erythrodysesthesia (17%), exanthema (14%) and mucositis (12%).

CONCLUSIONS

Efficacy and toxicity data in these "real life" patients permit the conclusion that PLD is a valuable option in the treatment of advanced breast cancer even in heavily pretreated patients.

摘要

背景

在晚期乳腺癌中,经常应用多种序贯的治疗方法。多柔比星脂质体(PLD)具有良好的毒性特征,可用于一线或更高线的治疗。PLD 甚至在先前使用蒽环类药物治疗后也具有反应活性。

方法

129 例连续的晚期乳腺癌患者,其中大多数患者接受了大量的预处理,在许可的批准下接受 PLD 单药治疗,记录其疗效和毒性。

结果

在常规治疗环境中,PLD 的剂量略低(中位数,每个周期 40mg/m2)。客观缓解率(完全和部分缓解)为 26%,19%的患者病情稳定。无进展生存期(PFS)和总生存期(OS)分别为 5.8 个月和 14.2 个月。无论患者是否已接受蒽环类药物治疗,反应率和 PFS 均无差异。有趣的是,无论 PLD 是作为一线、二线还是三线的姑息治疗,其 PFS 均相似。此外,有反应或病情稳定的患者的 PFS 和 OS 相似,这强调了疾病稳定与显著临床获益相关的观点。报告的最常见副作用是掌跖红斑感觉异常(17%)、皮疹(14%)和黏膜炎(12%)。

结论

这些“真实世界”患者的疗效和毒性数据表明,PLD 是晚期乳腺癌治疗的一种有价值的选择,即使是在接受过多重预处理的患者中也是如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd14/3178544/bd0eea9f8392/1471-2407-11-373-1.jpg

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