Moscetti L, Vici P, Gamucci T, Natoli C, Cortesi E, Marchetti P, Santini D, Giuliani R, Sperduti I, Mauri M, Pizzuti L, Mancini M L, Fabbri M A, Magri V, Iezzi L, Sini V, D'Onofrio L, Mentuccia L, Vaccaro A, Ramponi S, Roma C L, Ruggeri E M
Division of Oncology, Complesso Ospedaliero Belcolle, AUSL Viterbo, Viterbo, Italy; Department of Oncology and Haematology, Azienda Ospedaliera Policlinico, Modena, Italy.
Division of Medical Oncology B, Regina Elena National Cancer Institute, Rome, Italy.
Breast. 2016 Oct;29:96-101. doi: 10.1016/j.breast.2016.07.005. Epub 2016 Jul 29.
The everolimus and exemestane combination represents a treatment option for the endocrine sensitive metastatic breast cancer (MBC) patients. The toxicity profile reported in the Bolero 2 trial showed the feasibility in the selected patients. Few data are available for the unselected population.
In order to evaluate the safety in the unselected population of the clinical practice and to evaluate a possible association of toxicities with previous treatments, clinical data from 181 consecutive patients were retrospectively collected.
Due to toxic events, everolimus dosage was reduced to 5 mg in 27% of patients. No association was found in the analysis between toxicity and number of prior therapies, neither between toxicity and response. In the multivariate analysis the previous exposure to anthracyclines for advanced disease represents the only predictive factor of developing grade ≥2 toxicity (OR = 2.85 CI 95% 1.07-7.59, p = 0.036).
The association of everolimus and exemestane has confirmed to be a safe and effective treatment for endocrine sensitive MBC patients even in routine clinical practice. The rate of treatment discontinuation due to toxicity is low and none association between previous number of treatments and response or between toxicity and response was found.
依维莫司与依西美坦联合用药是内分泌敏感型转移性乳腺癌(MBC)患者的一种治疗选择。在Bolero 2试验中报告的毒性特征表明该治疗方案在选定患者中具有可行性。但关于未选定人群的数据较少。
为了评估该联合用药方案在临床实践中未选定人群的安全性,并评估毒性与既往治疗之间可能存在的关联,我们回顾性收集了181例连续患者的临床数据。
由于毒性事件,27%的患者依维莫司剂量减至5 mg。在分析中未发现毒性与既往治疗次数之间、毒性与反应之间存在关联。在多变量分析中,既往因晚期疾病接受过蒽环类药物治疗是发生≥2级毒性的唯一预测因素(OR = 2.85,95%CI 1.07 - 7.59,p = 0.036)。
即使在常规临床实践中,依维莫司与依西美坦联合用药已证实是内分泌敏感型MBC患者安全有效的治疗方案。因毒性导致治疗中断的发生率较低,且未发现既往治疗次数与反应之间、毒性与反应之间存在关联。