Zagouri Flora, Sergentanis Theodoros N, Chrysikos Dimosthenis, Dimopoulos Meletios-Athanasios, Psaltopoulou Theodora
Department of Clinical Therapeutics, Medical School, Alexandra Hospital, University of Athens, Vas Sofias Ave & Lourou str, 11521, Athens, Greece,
Breast Cancer Res Treat. 2015 Jan;149(1):269-75. doi: 10.1007/s10549-014-3240-z. Epub 2014 Dec 18.
Male breast cancer is an uncommon malignancy; little is known regarding hormonal manipulations for tamoxifen-resistant male breast cancer patients. This is the first pooled analysis of the literature to synthesize all available data and to evaluate the efficacy and safety of fulvestrant in male breast cancer. This study was performed in accordance with the PRISMA guidelines. All studies that examined the efficacy of fulvestrant in male breast cancer, regardless of sample size, were considered eligible. The search strategy retrieved 31 articles; of these, five articles were eligible (23 patients) for this pooled analysis. The mean age of the study sample was 63.1 years. Adjuvant hormonal treatment was administered in 87.5 % of cases. Fulvestrant was given as first or second line in 40 % of patients, while as third line or beyond in 60 % of patients. 79.0 % of patients at fulvestrant administration had visceral metastases. Regarding best response, in 26.1 % PR was achieved, in 47.8 % of cases SD was recorded, whereas in 26.1 % of patients PD was noted. The median PFS was equal to 5 months. No grade 3 and 4 adverse events were recorded; of note, hot flashes were reported in 18.2 % of male breast cancer patients. Fulvestrant may potentially play a promising role in the optimal therapeutic strategy for male patients with breast cancer diagnosis. However, further clinical and pharmacokinetic investigations are more than warranted before fulvestrant use becomes a common practice in male breast cancer patients.
男性乳腺癌是一种罕见的恶性肿瘤；对于他莫昔芬耐药的男性乳腺癌患者的激素治疗知之甚少。这是首次对文献进行汇总分析，以综合所有可用数据并评估氟维司群在男性乳腺癌中的疗效和安全性。本研究按照PRISMA指南进行。所有研究氟维司群在男性乳腺癌中疗效的研究，无论样本量大小，均被视为符合条件。检索策略共检索到31篇文章；其中，5篇文章（23例患者）符合本汇总分析的条件。研究样本的平均年龄为63.1岁。87.5%的病例接受了辅助激素治疗。40%的患者将氟维司群作为一线或二线治疗药物，而60%的患者将其作为三线或更晚线的治疗药物。接受氟维司群治疗的患者中有79.0%发生了内脏转移。关于最佳反应，26.1%的患者达到部分缓解（PR），47.8%的病例疾病稳定（SD），而26.1%的患者疾病进展（PD）。中位无进展生存期（PFS）为5个月。未记录到3级和4级不良事件；值得注意的是，18.2%的男性乳腺癌患者报告有潮热症状。氟维司群可能在男性乳腺癌患者的最佳治疗策略中发挥有前景的作用。然而，在氟维司群成为男性乳腺癌患者的常规治疗方法之前，进一步的临床和药代动力学研究是非常必要的。
