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[中国HER2阳性早期乳腺癌曲妥珠单抗辅助治疗:初步结果]

[Chinese HER2 positive early breast cancer trastuzumab adjuvant therapy: preliminary outcomes].

作者信息

Zhang Pin, Yu Shi-ying, Shen Zhen-zhou, Song San-tai, Guan Zhong-zhen, Jiao Shun-chang, Zheng Shu, Xu Guang-wei, Feng Feng-yi

机构信息

Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing100021, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Dec 18;92(47):3345-9.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of 1-year adjuvant trastuzumab (herceptin) versus 1-year non-trastuzumab observation in Chinese patients with HER2-positive early breast cancer during a median follow-up of 1 year.

METHODS

The HERA trial was an international, multicenter, randomized, open-label, phase III trial comparing treatment with trastuzumab for 1 and 2 years with observation after standard adjuvant chemotherapy, radiotherapy or both in patients with HER2-positive node-positive or high-risk node-negative early breast cancer. The primary endpoint was disease-free survival. Secondary end points included recurrence-free survival, distant disease-free survival, overall survival and cardiac safety. The first planned interim analysis comparing the efficacy and safety of treatment with trastuzumab for 1 year versus observation were completed in April 2005. Only the outcomes of recruited Chinese patients were reported.

RESULTS

A total of 122 Chinese patients from 8 participating centers were included for planned interim analysis. And they were divided into trastuzumab (n = 68) and observation (n = 54) groups. Three and eight disease-free survival events were observed in the trastuzumab and observation groups respectively. Two-year disease-free survival rates were 92.9% and 81.4% respectively (P = 0.0489); 2-year recurrence-free survival and distant disease-free survivals were 98.1% vs 81.4% (P = 0.0064) and 98.1% vs 83.3% (P = 0.0117) respectively. Trastuzumab was generally well-tolerated with a decent safety profile. Severe cardiotoxicity was not observed.

CONCLUSION

One-year treatment with adjuvant trastuzumab improves disease-free survival, recurrence-free survival and distant disease-free survival in Chinese patients with HER2-positive early breast cancer.

摘要

目的

在中位随访1年期间,评估1年辅助曲妥珠单抗(赫赛汀)与1年非曲妥珠单抗观察治疗对HER2阳性早期乳腺癌中国患者的疗效和安全性。

方法

HERA试验是一项国际多中心、随机、开放标签的III期试验,比较HER2阳性淋巴结阳性或高危淋巴结阴性早期乳腺癌患者在接受标准辅助化疗、放疗或两者联合治疗后,使用曲妥珠单抗治疗1年和2年与观察治疗的效果。主要终点是无病生存期。次要终点包括无复发生存期、远处无病生存期、总生存期和心脏安全性。2005年4月完成了首次计划的中期分析,比较了1年曲妥珠单抗治疗与观察治疗的疗效和安全性。仅报告了入组中国患者的结果。

结果

来自8个参与中心的122例中国患者被纳入计划的中期分析。他们被分为曲妥珠单抗组(n = 68)和观察组(n = 54)。曲妥珠单抗组和观察组分别观察到3例和8例无病生存事件。两年无病生存率分别为92.9%和81.4%(P = 0.0489);两年无复发生存率和远处无病生存率分别为98.1%对81.4%(P = 0.0064)和98.1%对83.3%(P = 0.0117)。曲妥珠单抗总体耐受性良好,安全性良好。未观察到严重心脏毒性。

结论

1年辅助曲妥珠单抗治疗可提高HER2阳性早期乳腺癌中国患者的无病生存期、无复发生存期和远处无病生存期。

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