Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland).
Department of Histology and Embryology, Bengbu Medical College, Bengbu, Anhui, China (mainland).
Med Sci Monit. 2017 Sep 28;23:4657-4664. doi: 10.12659/msm.905300.
BACKGROUND This study aimed to compare the efficacy and safety of vinorelbine plus cisplatin (NP regimen) vs. gemcitabine plus cisplatin (GP regimen) for treatment of metastatic TNBC after failure with anthracyclines and taxanes. MATERIAL AND METHODS A total of 48 patients with metastatic TNBC that failed in anthracyclines and taxanes treatment were enrolled and randomly grouped. Patients in the NP group (n=22) were given 25 mg/m² vinorelbine on days 1 and 8 and 25 mg/m² cisplatin on days 2-4 of each 21-day cycle, while subjects in the GP group (n=26) were administered 1000 mg/m² gemcitabine on days 1 and 8 and 25 mg/m² cisplatin on days 2-4 of each 21-day cycle. The treatment response and adverse events were compared between the 2 groups every 2 cycles. RESULTS The ORR, DCR, and median TTP were 45.5%, 77.3%, and 5 months in the NP group, and 46.2%, 80.8%, and 5.2 months in the GP group, and no significant differences were observed in ORR, DCR, and median TTP between the 2 groups (P>0.05). The major adverse events included grade I-II bone marrow inhibition, gastrointestinal reactions, and phlebitis, and a lower incidence of thrombocytopenia and rash and a higher incidence of phlebitis was found in the NP group than in the GP group (P<0.05). CONCLUSIONS Either NP or GP regimen is active and tolerated in treatment of metastatic TNBC with anthracyclines and/or taxanes resistance, which may be used as a salvage treatment for metastatic TNBC.
本研究旨在比较长春瑞滨联合顺铂(NP 方案)与吉西他滨联合顺铂(GP 方案)治疗蒽环类和紫杉类药物治疗失败的转移性三阴性乳腺癌(mTNBC)的疗效和安全性。
共纳入 48 例蒽环类和紫杉类药物治疗失败的 mTNBC 患者,按随机数字表法分为 NP 组(n=22)和 GP 组(n=26)。NP 组患者接受长春瑞滨 25 mg/m²,第 1、8 天;顺铂 25 mg/m²,第 2-4 天,每 21 天为 1 个周期;GP 组患者接受吉西他滨 1000 mg/m²,第 1、8 天;顺铂 25 mg/m²,第 2-4 天,每 21 天为 1 个周期。每 2 个周期评价 2 组患者的治疗应答情况和不良反应。
NP 组和 GP 组的客观缓解率(ORR)、疾病控制率(DCR)和中位无进展生存期(TTP)分别为 45.5%、77.3%和 5 个月和 46.2%、80.8%和 5.2 个月,2 组间 ORR、DCR 和中位 TTP 比较,差异均无统计学意义(P>0.05)。主要不良反应为Ⅰ-Ⅱ级骨髓抑制、胃肠道反应和静脉炎,NP 组血小板减少和皮疹发生率低于 GP 组,静脉炎发生率高于 GP 组,差异均有统计学意义(P<0.05)。
NP 方案和 GP 方案治疗蒽环类和紫杉类药物耐药的转移性 TNBC 均有效且可耐受,可作为转移性 TNBC 的挽救治疗。