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接受来曲唑联合瑞博西利治疗的激素受体阳性、人表皮生长因子受体 2 阴性晚期乳腺癌绝经后女性的健康相关生活质量:MONALEESA-2 研究结果

Health-related quality of life of postmenopausal women with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer treated with ribociclib + letrozole: results from MONALEESA-2.

机构信息

Department of Oncology, Cumming School of Medicine, Tom Baker Cancer Centre, University of Calgary, 1331 29th Street NW, Calgary, AB, T2N 4N2, Canada.

Texas Oncology-Baylor Charles A. Sammons Cancer Center, Baylor University Medical Center, and The US Oncology Network, 3410 Worth Street, Suite 400, Dallas, TX, 75246, USA.

出版信息

Breast Cancer Res Treat. 2018 Aug;170(3):535-545. doi: 10.1007/s10549-018-4769-z. Epub 2018 Apr 13.

Abstract

PURPOSE

Evaluate patient-reported outcomes (PROs) for postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer treated with first-line ribociclib plus letrozole.

METHODS

In the phase III MONALEESA-2 study (NCT01958021), 668 patients were randomized 1:1 to ribociclib (600 mg/day; 3-weeks-on/1-week-off) plus letrozole (2.5 mg/day) or placebo plus letrozole. PROs were assessed using the European Organisation for Research and Treatment of Cancer core quality-of-life (EORTC QLQ-C30) and breast cancer-specific (EORTC QLQ-BR23) questionnaires. Changes from baseline and time to deterioration in health-related quality of life (HRQoL) were analyzed using linear mixed-effect and stratified Cox regression models, respectively. Exploratory analysis of area-under-the-curve for change from baseline in pain score (AUC-pain) was performed.

RESULTS

On-treatment HRQoL scores were consistently maintained from baseline and were similar between arms. A clinically meaningful (> 5 points) reduction in pain score was observed as early as Week 8 and was maintained up to Cycle 15 in the ribociclib arm. A statistically significant increase in mean AUC-pain was also observed in the ribociclib arm. Scores for all other EORTC QLQ-C30 and EORTC QLQ-BR23 domains were maintained from baseline and were similar between arms.

CONCLUSIONS

HRQoL was consistently maintained from baseline in postmenopausal women with HR+, HER2- advanced breast cancer receiving ribociclib plus letrozole and was similar to that observed in the placebo plus letrozole arm. Together with the improved clinical efficacy and manageable safety profile, these PRO results provide additional support for the benefit of ribociclib plus letrozole in this patient population.

摘要

目的

评估激素受体阳性(HR+)、人表皮生长因子受体 2 阴性(HER2-)晚期乳腺癌绝经后女性患者的患者报告结局(PROs),这些患者接受一线治疗时接受了来曲唑联合瑞博西利治疗。

方法

在 III 期 MONALEESA-2 研究(NCT01958021)中,668 名患者按照 1:1 比例随机分组,分别接受瑞博西利(600 mg/天;每 3 周用药 1 周停药)+来曲唑(2.5 mg/天)或安慰剂+来曲唑治疗。采用欧洲癌症研究与治疗组织核心生活质量问卷(EORTC QLQ-C30)和乳腺癌特异性问卷(EORTC QLQ-BR23)评估 PROs。采用线性混合效应模型和分层 Cox 回归模型分别分析自基线变化和健康相关生活质量(HRQoL)恶化的时间。还进行了基线变化时疼痛评分(AUC-pain)曲线下面积的探索性分析。

结果

治疗期间 HRQoL 评分自基线保持稳定,且两组间相似。瑞博西利组观察到疼痛评分早在第 8 周就出现有临床意义(>5 分)的降低,并在瑞博西利组一直维持至第 15 个周期。瑞博西利组还观察到平均 AUC-pain 显著增加。EORTC QLQ-C30 和 EORTC QLQ-BR23 所有其他领域的评分自基线保持稳定,且两组间相似。

结论

在接受来曲唑联合瑞博西利治疗的 HR+、HER2-晚期乳腺癌绝经后女性中,自基线起 HRQoL 保持稳定,且与安慰剂联合来曲唑组相似。这些 PRO 结果与改善的临床疗效和可管理的安全性特征一起,为来曲唑联合瑞博西利在这一患者人群中的获益提供了额外支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/444a/6022531/4b593b9e06c8/10549_2018_4769_Fig1_HTML.jpg

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