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在中国乳腺癌患者中,每周使用纳米白蛋白结合紫杉醇和顺铂联合治疗的Ⅱ期临床试验中皮疹发生率较高。

Higher rate of skin rash in a phase II trial with weekly nanoparticle albumin-bound paclitaxel and cisplatin combination in Chinese breast cancer patients.

出版信息

BMC Cancer. 2013 May 9;13:232. doi: 10.1186/1471-2407-13-232.

Abstract

BACKGROUND

The aim of this sub-study is to explore the incidence of skin rash among advanced breast cancer(ABC) patients in a phase II trial treated with weekly nab-paclitaxel and cisplatin combination.

METHODS

Nab-paclitaxel(125 mg/m2) was administered on days 1, 8, 15, followed by cisplatin(75 mg/m2) on day 1 every 28 day cycle until disease progression, intolerable toxicities or the maximum of 6 cycles. Patients who received at least one injection of the study drug were included in this analysis of the incidence of skin rash among Chinese patients. Toxicity was graded using the CTCAE4.0 criteria. Statistical analysis was carried out by using SPSS 16.0 (SPSS Inc, Chicago, IL).

RESULTS

Seventy three patients were enrolled and eligible for analysis. A total of 384 cycles were administered at the time of this analysis. Rash was presented in 27 patients (37.0%). The most common sites involved were face (14/27), neck (14/27), limbs (18/27) and frictional parts of the trunk (10/27). Macular and papular rash with pruritus commonly occurred 2 (95% CI: 1-7) days after the first day of chemotherapy. Only one patient developed Grade 3 skin toxicity with generalized erythroderma and disfigurement of the face requiring dose reduction. The rash gradually regressed 2 (95% CI: 1-10) days after antihistamines used, but pigmentation remained in 13/27 cases. The incidence rate of skin rash was significantly higher than what has been described for western patients (approximate 4%, P < 0.0001).

CONCLUSION

A higher rate of maculo-papular rash occurred in Chinese breast cancer patients treated with weekly nab-paclitaxel compared to western patients. The albumin component of nab-paclitaxel might be the cause of the skin disorder.

TRIAL REGISTRATION

NCT01149798.

摘要

背景

本研究旨在探讨每周给予 nab-紫杉醇联合顺铂方案治疗晚期乳腺癌(ABC)患者中皮疹的发生率。

方法

nab-紫杉醇(125mg/m2)于第 1、8、15 天给药,随后每 28 天周期的第 1 天给予顺铂(75mg/m2),直至疾病进展、无法耐受的毒性或最多 6 个周期。至少接受一次研究药物注射的患者被纳入本分析。使用 CTCAE4.0 标准评估毒性。使用 SPSS 16.0(SPSS Inc,芝加哥,IL)进行统计分析。

结果

共纳入 73 例患者,可进行分析。在本次分析时共给予 384 个周期。27 例患者(37.0%)出现皮疹。最常见的受累部位是面部(14/27)、颈部(14/27)、四肢(18/27)和摩擦部位的躯干(10/27)。斑丘疹伴瘙痒通常在化疗第 1 天之后 2 天(95%CI:1-7)出现。仅有 1 例患者发生 3 级皮肤毒性,表现为全身性红皮病和面部毁容,需要减少剂量。皮疹在使用抗组胺药后 2 天(95%CI:1-10)逐渐消退,但 13/27 例仍有色素沉着。皮疹的发生率明显高于西方患者(约 4%,P<0.0001)。

结论

每周给予 nab-紫杉醇治疗的中国乳腺癌患者发生斑丘疹的比例高于西方患者。nab-紫杉醇的白蛋白成分可能是导致皮肤紊乱的原因。

试验注册

NCT01149798。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d312/3658926/6f165026b894/1471-2407-13-232-1.jpg

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