Linderholm B K, Lidbrink E, Tallroth E, Einbeigi Z, Svensson H, von Wachenfeldt A, Norberg B, Carlsson L, Olsson M E, Bergh J, Wilking N, Hatschek T
Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden.
Breast. 2013 Dec;22(6):1142-7. doi: 10.1016/j.breast.2013.07.041. Epub 2013 Aug 20.
Several anticancer agents including paclitaxel have an inhibitory effect on angiogenesis.
To compare the overall response rate and time to progression with changes in circulating angiogenic factors during palliative treatment with weekly paclitaxel.
Patients with metastatic BC, ECOG 0-2, received weekly paclitaxel, concomitant with trastuzumab if HER2+ BC (n = 7). Circulating vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were determined at base-line and before start of new course.
Fifty-five of 63 included patients were evaluable. The overall response rate including stable disease ≥24 weeks (CR + PD + SD) was obtained in 25 of the evaluable patients (45%). The median time to progression (TTP) was 5.3 months and overall survival (OS) 16.7 months. Patients with triple negative breast cancer (TNBC) showed a trend towards higher base-line VEGF compared with hormone receptor positive or HER2+ tumours and had shorter TTP. Significant differences in VEGF and bFGF levels at 12 weeks were found between patients with longer versus shorter TTP (VEGF: p = 0.046, bFGF: p = 0.005) and between patients gaining versus lacking clinical benefit (VEGF: p = 0.05, bFGF: p = 0.02).
The clinical utility of circulating VEGF may be a useful tool for monitoring treatment efficacy.
包括紫杉醇在内的几种抗癌药物对血管生成具有抑制作用。
比较每周使用紫杉醇进行姑息治疗期间的总缓解率和疾病进展时间与循环血管生成因子变化情况。
转移性乳腺癌患者，ECOG 0 - 2，接受每周一次紫杉醇治疗，HER2 + 乳腺癌患者（n = 7）同时接受曲妥珠单抗治疗。在基线期和新疗程开始前测定循环血管内皮生长因子（VEGF）和碱性成纤维细胞生长因子（bFGF）。
纳入的63例患者中有55例可评估。25例可评估患者（45%）获得了包括疾病稳定≥24周（CR + PD + SD）的总缓解率。中位疾病进展时间（TTP）为5.3个月，总生存期（OS）为16.7个月。三阴性乳腺癌（TNBC）患者与激素受体阳性或HER2 + 肿瘤患者相比，基线VEGF有升高趋势，且TTP较短。TTP较长与较短的患者之间以及获得与未获得临床获益的患者之间，在12周时VEGF和bFGF水平存在显著差异（VEGF：p = 0.046，bFGF：p = 0.005）以及（VEGF：p = 0.05，bFGF：p = 0.02）。
循环VEGF的临床效用可能是监测治疗疗效的有用工具。
