Division of Medical Oncology, University of Lisboa Medical School, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
Division of Medical Oncology, Hospital de Clinicas, State University Medical School of Campinas, Campinas, Brazil.
Ann Oncol. 2012 Mar;23(3):547-555. doi: 10.1093/annonc/mdr382. Epub 2011 Sep 6.
Despite current trend of targeted therapy development, cytotoxic agents are a mainstay of treatment of patients with breast cancer. We reviewed recent advances in cytotoxic therapy for patients with metastatic breast cancer (MBC).
Medline searches were conducted for English language studies using the term 'MBC' and 'cytotoxic drugs'. The data search was restricted to the period 2000-2011.
Several novel cytotoxic compounds, all microtubule inhibitors, have been approved for clinical use in MBC: (i) nab-paclitaxel, reported to improve tumour response and decrease hypersensitivity reactions in comparison with other taxanes; (ii) ixabepilone, shown to have clinical benefit in taxane- and anthracycline-resistant disease and (iii) eribulin, shown to improve overall survival in heavily pre-treated patients, when compared with best available standard treatment. Agents, such as larotaxel, vinflunine, trabectidin and formulations, including cationic liposomal paclitaxel or paclitaxel poliglumex, are currently under evaluation in phase II/III trials.
Toxicity and chemotherapy resistance are still major limitations in the treatment of patients with MBC. Further research into new cytotoxic compounds is needed in order to maximise benefit, whilst minimising toxicity.
尽管目前靶向治疗的发展趋势，细胞毒性药物仍然是治疗乳腺癌患者的主要方法。我们回顾了转移性乳腺癌（MBC）患者细胞毒治疗的最新进展。
用术语“MBC”和“细胞毒药物”在 Medline 上进行英语研究的搜索。数据搜索仅限于 2000 年至 2011 年期间。
几种新型细胞毒性化合物，均为微管抑制剂，已获准在 MBC 中临床使用：（i）nab-紫杉醇，据报道与其他紫杉烷类药物相比，能提高肿瘤反应并减少过敏反应；（ii）伊沙匹隆，已显示在紫杉烷类和蒽环类耐药疾病中有临床获益；（iii）艾日布林，与最佳可用标准治疗相比，在接受过多线治疗的患者中，改善了总体生存。拉罗他赛、vinflunine、 trabectidin 等药物，以及阳离子脂质体紫杉醇或紫杉醇聚谷氨酸制剂，目前正在 II/III 期临床试验中进行评估。
毒性和化疗耐药性仍然是治疗 MBC 患者的主要限制。为了最大限度地提高疗效，同时最大限度地降低毒性，需要对新的细胞毒性化合物进行进一步研究。
