Sun Bing, Zhao Xin, Ding Lijuan, Meng Xiangying, Song Santai, Wu Shikai
Department of Radiotherapy, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
Department of Radiotherapy, Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
Oncotarget. 2016 Sep 6;7(36):57894-57902. doi: 10.18632/oncotarget.11082.
To evaluate the efficacy and safety of single-agent sunitinib as salvage treatment in Chinese patients with multidrug-resistant metastatic breast cancer (MBC).
37 patients were enrolled with median age of 48 years. 17 had hormone receptor (HR)-positive tumors, 7 had HER2-positive tumors, and 10 had triple-negative tumors. Among 32 evaluable patients with follow-up, 6 (18.8%) achieved partial response, 14 (43.8%) achieved stable disease, and 11 (34.4%) exhibited tumor shrinkage. The response rate in 9 patients with carcinomatous ulcers was 77.8%. The median progression free survival (PFS) was 8.6 weeks. Patients with a better response had improved overall survival and PFS relative to patients with a worse response (p = 0.007, p < 0.001). Compared with HR-negative tumor, HR-positive tumor had significantly better response to sunitinib (p = 0.035). The most frequent non-hematologic adverse events were fatigue (82.8%) and hypertension (34.5%). Grade 3/4 hematologic toxicity included neutropenia (82.8%) and thrombocytopenia (79.3%). There was no correlation between the clinical response and IHC findings.
Patients with MBC who were resistant to multiple salvage regimens (≥ 3 previous chemotherapy lines) were enrolled to receive sunitinib monotherapy. Dosage adjustment was allowed depending on adverse events. 14 patients underwent immunohistochemistry (IHC) testing for VEGF, PDGFR, EGFR and c-KIT.
Sunitinib salvage treatment provided modest antitumor effect to patients with refractory multidrug-resistant MBC, especially to those with troublesome carcinomatous ulcers. The treatment-related adverse events of sunitinib were manageable through dosage adjustment.
评估单药舒尼替尼作为挽救治疗方案在中国多药耐药转移性乳腺癌（MBC）患者中的疗效和安全性。
共纳入37例患者，中位年龄48岁。其中17例为激素受体（HR）阳性肿瘤，7例为HER2阳性肿瘤，10例为三阴性肿瘤。在32例可评估且有随访结果的患者中，6例（18.8%）获得部分缓解，14例（43.8%）疾病稳定，11例（34.4%）肿瘤缩小。9例患有癌性溃疡的患者缓解率为77.8%。中位无进展生存期（PFS）为8.6周。与缓解较差的患者相比，缓解较好的患者总生存期和无进展生存期均有所改善（p = 0.007，p < 0.001）。与HR阴性肿瘤相比，HR阳性肿瘤对舒尼替尼的反应明显更好（p = 0.035）。最常见的非血液学不良事件为疲劳（82.8%）和高血压（34.5%）。3/4级血液学毒性包括中性粒细胞减少（82.8%）和血小板减少（79.3%）。临床反应与免疫组化结果之间无相关性。
纳入对多种挽救方案（≥3线既往化疗方案）耐药的MBC患者接受舒尼替尼单药治疗。根据不良事件情况允许调整剂量。14例患者接受了血管内皮生长因子（VEGF）、血小板衍生生长因子受体（PDGFR）、表皮生长因子受体（EGFR）和c-KIT的免疫组化（IHC）检测。
舒尼替尼挽救治疗为难治性多药耐药MBC患者提供了一定的抗肿瘤效果，尤其是对那些伴有棘手癌性溃疡的患者。通过调整剂量，舒尼替尼治疗相关的不良事件是可控的。
