Kim Jung Sun, Park In Hae, Lee Keun Seok, Ro Jungsil
Center for Breast Cancer, National Cancer Center, Goyang, Korea.
J Breast Cancer. 2014 Dec;17(4):339-43. doi: 10.4048/jbc.2014.17.4.339. Epub 2014 Dec 26.
The combination of gemcitabine and cisplatin (GP) has been shown to be safe and efficacious for patients with metastatic breast cancer (MBC), pretreated with anthracyclines and taxanes. We assessed the efficacy and safety of weekly low-dose GP in patients with MBC.
We collected clinicopathological data from MBC patients who had been treated with gemcitabine, 800 mg/m(2) plus cisplatin, 30 mg/m(2) intravenously, on days 1 and 8 every 3 weeks, between January 2001 and November 2011 in Korea.
The analysis included 294 patients previously treated anthracycline-xand taxane-based chemotherapies prior to GP (median age, 48 years [range, 28-78 years]; median follow-up duration, 63.9 months). Seventeen patients (5.8%) discontinued GP because of toxicities. The median progression-free survival (PFS) was 3.9 months (95% confidence interval [CI], 3.394.4 months) and the median overall survival (OS) was 27.7 months (95% CI, 17.6-37.8 months) months. Statistically significant factors for PFS were performance status (Eastern Cooperative Oncology Group, ≥2 vs. <2; hazard ratio [HR], 1.37; 95% CI, 1.02-1.85; p=0.037), distant disease-free interval (DDFI; ≤2 years vs. >2 years; HR, 1.66; 95% CI, 1.28-1.95, p<0.001), time interval from the diagnosis of metastasis to GP therapy (≤1 year vs. >1 year; HR, 1.48; 95% CI, 1.13-1.95, p<0.001), and presence of brain metastasis (HR, 1.47; 95% CI, 1.03-2.10; p=0.031). Similarly, DDFI (≤2 years vs. >2 years; HR, 2.07; 95% CI, 1.36-3.14; p<0.001) and the presence of brain metastasis (HR, 2.14; 95% CI, 1.27-3.61; p=0.004) were important factors for OS after GP treatment.
Weekly low-dose GP chemotherapy appears safe and effective for heavily pretreated MBC patients.
吉西他滨和顺铂联合方案（GP）已被证明对接受过蒽环类药物和紫杉烷类药物预处理的转移性乳腺癌（MBC）患者安全有效。我们评估了每周低剂量GP方案治疗MBC患者的疗效和安全性。
我们收集了2001年1月至2011年11月期间在韩国接受治疗的MBC患者的临床病理数据，这些患者每3周的第1天和第8天静脉注射吉西他滨800mg/m²加顺铂30mg/m²。
分析纳入了294例在接受GP治疗前接受过基于蒽环类药物和紫杉烷类药物化疗的患者（中位年龄48岁[范围28 - 78岁]；中位随访时间63.9个月）。17例患者（5.8%）因毒性反应停用GP。中位无进展生存期（PFS）为3.9个月（95%置信区间[CI]，3.3 - 4.4个月），中位总生存期（OS）为27.7个月（95% CI，17.6 - 37.8个月）。PFS的统计学显著因素包括体能状态（东部肿瘤协作组，≥2 vs. <2；风险比[HR]，1.37；95% CI，1.02 - 1.85；p = 0.037）、无远处疾病间期（DDFI；≤2年vs. >2年；HR，1.66；95% CI，1.28 - 1.95，p < 0.001）、从转移诊断到GP治疗的时间间隔（≤1年vs. >1年；HR，1.48；95% CI，1.13 - 1.95，p < 0.001）以及脑转移的存在（HR，1.47；95% CI，1.03 - 2.10；p = 0.031）。同样，DDFI（≤2年vs. >2年；HR，2.07；95% CI，1.36 - 3.14；p < 0.001）和脑转移的存在（HR，2.14；95% CI，1.27 - 3.61；p = 0.004）是GP治疗后OS的重要因素。
每周低剂量GP化疗对于预处理严重的MBC患者似乎安全有效。
