Li Shufen, Meng Wenjing, Zhang Jibo, Xie Xiaojuan, Hao Chunfang, Jia Yongsheng, Tong Zhongsheng
Department of Breast Oncology, Cancer Hospital of Tianjin, Department of Breast Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Department of Oncology, Hebei Province Xingtai People's Hospital, Hebei Medical University Affiliated Hospital, Xingtai, China.
J Cancer Res Ther. 2020 Sep;16(5):1069-1076. doi: 10.4103/jcrt.JCRT_792_19.
Previous studies have shown that vinorelbine/capecitabine (NX) and docetaxel/capecitabine (TX) chemotherapy has a certain effect in advanced breast cancer. However, there are few clinical studies directly comparing TX and NX regimen chemotherapy, especially in patients with advanced breast cancer previously treated with anthracycline and taxane. The purpose of this Phase II study was to compare survival and side effects between patients with anthracycline- and taxane-resistant advanced breast cancer treated with NX and those treated with TX chemotherapy.
From February 2012 to March 2014, a total number of 97 patients were randomly assigned to NX (n = 55) or TX (n = 42). Baseline characteristics were relatively well-balanced in the two treatment arms. The clinical trial registration number (clincaltrials.gov) is NCT01635465.
After a median follow-up of 46.0 months, there was no significant difference between the NX and TX arms in objective response rate (17.9% vs. 21.1%; P = 0.686) and progression-free survival (6 months vs. 7 months; P = 0.560). The overall survival period of the TX arm was longer than that of the NX arm (32 months vs. 27 months) but without statistical significance. Both regimens were well-tolerated. The main toxicities were neutropenia, leukopenia, and anemia. In the TX arm, hand-foot syndrome occurred more frequently than in the NX arm (P < 0.01), but frequencies of other minor adverse effects were similar between the two arms.
NX and TX regimens are both alternative treatments for patients with anthracycline- and taxane-resistant advanced breast cancer, but the safety profile was more favorable and manageable with the NX regimen.
ClinicalTrials.gov NCT01635465. Registered 09 July 2012.
既往研究表明,长春瑞滨/卡培他滨(NX)和多西他赛/卡培他滨(TX)化疗在晚期乳腺癌中具有一定疗效。然而,直接比较TX和NX方案化疗的临床研究较少,尤其是在既往接受过蒽环类和紫杉类治疗的晚期乳腺癌患者中。本II期研究的目的是比较接受NX化疗和TX化疗的蒽环类和紫杉类耐药晚期乳腺癌患者的生存情况和副作用。
2012年2月至2014年3月,共有97例患者被随机分配至NX组(n = 55)或TX组(n = 42)。两个治疗组的基线特征相对均衡。临床试验注册号(clincaltrials.gov)为NCT01635465。
中位随访46.0个月后,NX组和TX组在客观缓解率(17.9%对21.1%;P = 0.686)和无进展生存期(6个月对7个月;P = 0.560)方面无显著差异。TX组的总生存期长于NX组(32个月对27个月),但无统计学意义。两种方案耐受性均良好。主要毒性为中性粒细胞减少、白细胞减少和贫血。TX组手足综合征的发生率高于NX组(P < 0.01),但两组其他轻微不良反应的发生率相似。
NX和TX方案均为蒽环类和紫杉类耐药晚期乳腺癌患者的替代治疗方案,但NX方案的安全性更好且更易于管理。
ClinicalTrials.gov NCT01635465。于2012年7月9日注册。