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空腹血糖与接受靶向药物治疗的乳腺癌和结直肠癌患者的治疗结局:来自历史队列的结果。

Fasting glucose and treatment outcome in breast and colorectal cancer patients treated with targeted agents: results from a historic cohort.

机构信息

Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Temple University, Philadelphia, USA.

出版信息

Ann Oncol. 2012 Jul;23(7):1838-45. doi: 10.1093/annonc/mdr540. Epub 2011 Nov 18.

Abstract

BACKGROUND

We investigated pretreatment fasting glucose as a predictor of patients' important outcomes in breast and colorectal cancers undergoing targeted therapies.

PATIENTS AND METHODS

In a historic cohort of 202 breast and 218 colorectal cancers treated with targeted agents from 1998 to 2009, we used the Kaplan-Meier method and the log-rank test to estimate survival through tertiles of fasting glucose and the Cox proportional hazards model for multivariate analysis stratified by primary site of cancer and including gender, age and body mass index.

RESULTS

The median follow-up was 20 months (1-128). At 60 months, 65% of patients in the lowest tertile of fasting glucose did not experiment disease progression compared with 34% in the highest tertile (P=0.001). Seventy-six percent of females in the lowest tertile showed no progression compared with 49% in the top tertiles (P=0.015). In multivariate analysis, fasting glucose was a significant predictor of time to disease progression only in breast cancer patients in the first tertile compared with the third (P=0.017).

CONCLUSIONS

We found evidence of a predictive role of pretreatment fasting glucose in the development of resistance in breast cancer patients treated with targeted agents. Prospective studies are warranted to confirm our findings.

摘要

背景

我们研究了治疗前空腹血糖作为接受靶向治疗的乳腺癌和结直肠癌患者重要结局的预测因子。

患者和方法

在 1998 年至 2009 年期间接受靶向药物治疗的 202 例乳腺癌和 218 例结直肠癌的历史队列中,我们使用 Kaplan-Meier 方法和对数秩检验通过空腹血糖三分位值来估计生存,使用 Cox 比例风险模型进行多变量分析,按癌症的主要部位分层,并包括性别、年龄和体重指数。

结果

中位随访时间为 20 个月(1-128)。在 60 个月时,空腹血糖最低三分位的患者中有 65%未发生疾病进展,而最高三分位的患者中有 34%(P=0.001)。在最低三分位的女性中,76%未出现进展,而在最高三分位的女性中,这一比例为 49%(P=0.015)。多变量分析显示,空腹血糖仅在乳腺癌患者的第一三分位与第三三分位相比,是疾病进展时间的显著预测因子(P=0.017)。

结论

我们发现了治疗前空腹血糖在接受靶向药物治疗的乳腺癌患者中对耐药性发展具有预测作用的证据。需要进行前瞻性研究来证实我们的发现。

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