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帕博西尼治疗晚期乳腺癌患者的真实世界结局:日本一项多中心回顾性队列研究——KBCOG-14研究

Real-World Outcomes of Treating Advanced Breast Cancer Patients With Palbociclib: A Multicenter Retrospective Cohort Study in Japan-The KBCOG-14 Study.

作者信息

Odan Nina, Kikawa Yuichiro, Matsumoto Hajime, Minohata Junya, Suwa Hirofumi, Hashimoto Takashi, Okuno Toshitaka, Miyashita Masaru, Saito Masaru, Yamagami Kazuhiko, Takao Shintaro

机构信息

Department of Breast Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.

Department of Breast Surgery and Oncology, Shinko Hospital, Kobe, Japan.

出版信息

Breast Cancer (Auckl). 2020 Dec 28;14:1178223420983843. doi: 10.1177/1178223420983843. eCollection 2020.

DOI:10.1177/1178223420983843
PMID:33447040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7780165/
Abstract

BACKGROUND

Clinical studies have shown that palbociclib improves progression-free survival in hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) patients with advanced breast cancer (ABC). However, there are insufficient data on its use in a real-world setting in Japan. The aim of this study was to investigate the effectiveness, predictive factors, and safety of palbociclib among Japanese patients in routine clinical practice.

METHODS

Between December 1, 2017, and April 30, 2019, we recruited patients from 9 hospitals and retrospectively evaluated the data on HR+/HER2- patients with ABC who received palbociclib for at least 1 week. The correlation between time-to-treatment discontinuation (TTD) and clinical background was investigated via univariate and multivariate analyses using Cox hazards models.

RESULTS

A total of 177 women were available for analysis. Of these patients, 58 (33%) patients were treated with palbociclib with an aromatase inhibitor and 117 (66%) patients were treated with palbociclib and a selective estrogen receptor degrader. Approximately three-fourths of the patients (n = 130, 73%) received palbociclib as third- or later-line therapy. One-third of the patients had 3 or more metastatic sites (n = 59, 33%), and one-third of the patients had liver metastasis (n = 59, 33%). The median follow-up duration at the time of data cutoff was 8.9 months, the median TTD was 6.3 months, and the median overall survival was not reached. Liver metastasis (hazard ratio [HR]: 1.54 [95% confidence interval {CI}: 1.03-2.27]), high serum lactate dehydrogenase (LDH) level (>300 U/L) (HR: 2.58 [95% CI: 1.49-4.26]), and high neutrophil-to-lymphocyte ratio (NLR) (⩾3.0) (HR: 1.76 [95% CI: 1.13-2.69]) were significantly associated with shorter TTD. The most common hematologic adverse event was neutropenia, which occurred in 93% of the patients.

CONCLUSION

Based on the results of the pivotal phase 3 trials, the median TTD recorded in this study was shorter than expected. Our results suggest that liver metastasis, serum LDH level, and NLR may be predictive factors for HR+/HER2- ABC treatment outcomes.

摘要

背景

临床研究表明,哌柏西利可改善激素受体阳性(HR+)、人表皮生长因子受体2阴性(HER2-)的晚期乳腺癌(ABC)患者的无进展生存期。然而,关于其在日本真实临床环境中的应用数据不足。本研究的目的是调查哌柏西利在日本常规临床实践中的有效性、预测因素和安全性。

方法

在2017年12月1日至2019年4月30日期间,我们从9家医院招募患者,并回顾性评估了接受哌柏西利治疗至少1周的HR+/HER2- ABC患者的数据。使用Cox风险模型通过单因素和多因素分析研究治疗中断时间(TTD)与临床背景之间的相关性。

结果

共有177名女性可供分析。在这些患者中,58名(33%)患者接受哌柏西利联合芳香化酶抑制剂治疗,117名(66%)患者接受哌柏西利联合选择性雌激素受体降解剂治疗。约四分之三的患者(n = 130,73%)接受哌柏西利作为三线或更后线治疗。三分之一的患者有3个或更多转移部位(n = 59,33%),三分之一的患者有肝转移(n = 59,33%)。数据截止时的中位随访时间为8.9个月,中位TTD为6.3个月,中位总生存期未达到。肝转移(风险比[HR]:1.54 [95%置信区间{CI}:1.03 - 2.27])、高血清乳酸脱氢酶(LDH)水平(>300 U/L)(HR:2.58 [95% CI:1.49 - 4.26])和高中性粒细胞与淋巴细胞比值(NLR)(⩾3.0)(HR:1.76 [95% CI:1.13 - 该文档部分内容翻译存在重复,完整准确译文应如下:

背景

临床研究表明,哌柏西利可改善激素受体阳性(HR+)、人表皮生长因子受体2阴性(HER2-)的晚期乳腺癌(ABC)患者的无进展生存期。然而,关于其在日本真实临床环境中的应用数据不足。本研究的目的是调查哌柏西利在日本常规临床实践中的有效性、预测因素和安全性。

方法

在2017年12月1日至2019年4月30日期间,我们从9家医院招募患者,并回顾性评估了接受哌柏西利治疗至少1周的HR+/HER2- ABC患者的数据。使用Cox风险模型通过单因素和多因素分析研究治疗中断时间(TTD)与临床背景之间的相关性。

结果

共有177名女性可供分析。在这些患者中,58名(33%)患者接受哌柏西利联合芳香化酶抑制剂治疗,117名(66%)患者接受哌柏西利联合选择性雌激素受体降解剂治疗。约四分之三的患者(n = 130,73%)接受哌柏西利作为三线或更后线治疗。三分之一的患者有3个或更多转移部位(n = 59,33%),三分之一的患者有肝转移(n = 59,33%)。数据截止时的中位随访时间为8.9个月,中位TTD为6.3个月,中位总生存期未达到。肝转移(风险比[HR]:1.54 [95%置信区间{CI}:1.03 - 2.27])、高血清乳酸脱氢酶(LDH)水平(>300 U/L)(HR:(2.首先,文档中存在重复表述的问题,我先为你提供去除重复后的译文:

背景

临床研究表明,哌柏西利可改善激素受体阳性(HR+)、人表皮生长因子受体2阴性(HER2-)的晚期乳腺癌(ABC)患者的无进展生存期。然而,关于其在日本真实临床环境中的应用数据不足。本研究的目的是调查哌柏西利在日本常规临床实践中的有效性、预测因素和安全性。

方法

在2017年12月1日至2019年4月30日期间,我们从9家医院招募患者,并回顾性评估了接受哌柏西利治疗至少1周的HR+/HER2- ABC患者的数据。使用Cox风险模型通过单因素和多因素分析研究治疗中断时间(TTD)与临床背景之间的相关性。

结果

共有177名女性可供分析。在这些患者中,58名(33%)患者接受哌柏西利联合芳香化酶抑制剂治疗,117名(66%)患者接受哌柏西利联合选择性雌激素受体降解剂治疗。约四分之三的患者(n = 130,73%)接受哌柏西利作为三线或更后线治疗。三分之一的患者有3个或更多转移部位(n =

背景

临床研究表明,哌柏西利可改善激素受体阳性(HR+)、人表皮生长因子受体2阴性(HER2-)的晚期乳腺癌(ABC)患者的无进展生存期。然而,关于其在日本真实临床环境中的应用数据不足。本研究的目的是调查哌柏西利在日本常规临床实践中的有效性、预测因素和安全性。

方法

在2017年12月1日至2019年4月(此处“4月”后内容缺失,我先按完整格式翻译)30日期间,我们从9家医院招募患者,并回顾性评估了接受哌柏西利治疗至少1周的HR+/HER2- ABC患者的数据。使用Cox风险模型通过单因素和多因素分析研究治疗中断时间(TTD)与临床背景之间的相关性。

结果

共有177名女性可供分析。在这些患者中,58名(33%)患者接受哌柏西利联合芳香化酶抑制剂治疗,117名(66%)患者接受哌柏西利联合选择性雌激素受体降解剂治疗。约四分之三的患者(n = 130,73%)接受哌柏西利作为三线或更后线治疗。三分之一的患者有3个或更多转移部位(n = 59,33%),三分之一的患者有肝转移(n = 59,33%)。数据截止时的中位随访时间为8.9个月,中位TTD为6.3个月,中位总生存期未达到。肝转移(风险比[HR]:1.54 [95%置信区间{CI}:1.03 - 2.27])、高血清乳酸脱氢酶(LDH)水平(>300 U/L)(HR:2.58 [95% CI:1.49 - 4.26])和高中性粒细胞与淋巴细胞比值(NLR)(⩾3.0)(HR:1.76 [95% CI:1.13 - 2.69])与较短的TTD显著相关。最常见的血液学不良事件是中性粒细胞减少,93%的患者发生该事件。

结论

基于关键3期试验的结果,本研究记录的中位TTD短于预期。我们的结果表明,肝转移、血清LDH水平和NLR可能是HR+/HER2- ABC治疗结果的预测因素。

2.69])与较短的TTD显著相关。最常见的血液学不良事件是中性粒细胞减少,93%的患者发生该事件。

CONCLUSION

Based on the results of the pivotal phase 3 trials, the median TTD recorded in this study was shorter than expected. Our results suggest that liver metastasis, serum LDH level, and NLR may be predictive factors for HR+/HER2- ABC treatment outcomes.

结论

基于关键3期试验的结果,本研究记录的中位TTD短于预期。我们的结果表明,肝转移、血清LDH水平和NLR可能是HR+/HER2- ABC治疗结果的预测因素。

如果以上不是你想要的内容,请你检查文档是否完整准确,以便我能为你提供更符合需求的译文。 59,33%),三分之一的患者有肝转移(n = 59,33%)。数据截止时的中位随访时间为8.9个月,中位TTD为6.3个月,中位总生存期未达到。肝转移(风险比[HR]:1.54 [95%置信区间{CI}:1.03 - 2.27])、高血清乳酸脱氢酶(LDH)水平(>300 U/L)(HR:2.58 [95% CI:1.49 - 4.26])和高中性粒细胞与淋巴细胞比值(NLR)(⩾3.0)(HR:1.76 [95% CI:1.13 - 2.69])与较短的TTD显著相关。最常见的血液学不良事件是中性粒细胞减少,93%的患者发生该事件。

结论

基于关键3期试验的结果,本研究记录的中位TTD短于预期。我们的结果表明,肝转移、血清LDH水平和NLR可能是HR+/HER2- ABC治疗结果的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/122b/7780165/e5b9045bdafb/10.1177_1178223420983843-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/122b/7780165/bed6f838ec6b/10.1177_1178223420983843-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/122b/7780165/e5b9045bdafb/10.1177_1178223420983843-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/122b/7780165/bed6f838ec6b/10.1177_1178223420983843-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/122b/7780165/e5b9045bdafb/10.1177_1178223420983843-fig2.jpg

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Med Oncol. 2022 Jul 14;39(10):149. doi: 10.1007/s12032-022-01749-1.
9
Combination of palbociclib with adjuvant endocrine therapy for treatment of hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer: An experience at two cancer centers in Saudi Arabia.哌柏西利联合辅助内分泌治疗激素受体阳性且人表皮生长因子受体2阴性转移性乳腺癌:沙特阿拉伯两个癌症中心的经验
Mol Clin Oncol. 2022 Jun 1;17(1):119. doi: 10.3892/mco.2022.2552. eCollection 2022 Jul.
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Clinicopathological Features Related to the Efficacy of CDK4/6 Inhibitor-Based Treatments in Metastatic Breast Cancer.与基于CDK4/6抑制剂的治疗在转移性乳腺癌中的疗效相关的临床病理特征
Breast Cancer (Auckl). 2022 Jan 5;16:11782234211065148. doi: 10.1177/11782234211065148. eCollection 2022.
帕博西尼治疗日本晚期乳腺癌患者中性粒细胞减少症的管理。
Breast Cancer. 2019 Sep;26(5):637-650. doi: 10.1007/s12282-019-00970-7. Epub 2019 May 24.
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Prognostic significance of serum lactate dehydrogenase in patients with breast cancer: a meta-analysis.血清乳酸脱氢酶在乳腺癌患者中的预后意义:一项荟萃分析。
Cancer Manag Res. 2019 Apr 26;11:3611-3619. doi: 10.2147/CMAR.S199260. eCollection 2019.
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Real-world clinical outcomes and toxicity in metastatic breast cancer patients treated with palbociclib and endocrine therapy.帕博西尼联合内分泌治疗转移性乳腺癌患者的真实世界临床结局和毒性。
Breast Cancer Res Treat. 2019 Jul;176(2):429-434. doi: 10.1007/s10549-019-05176-1. Epub 2019 Mar 20.
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Cyclin E1 Expression and Palbociclib Efficacy in Previously Treated Hormone Receptor-Positive Metastatic Breast Cancer.细胞周期蛋白 E1 表达与帕博西尼在既往治疗的激素受体阳性转移性乳腺癌中的疗效。
J Clin Oncol. 2019 May 10;37(14):1169-1178. doi: 10.1200/JCO.18.00925. Epub 2019 Feb 26.
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Real-World Effectiveness of Palbociclib Versus Clinical Trial Results in Patients With Advanced/Metastatic Breast Cancer That Progressed on Previous Endocrine Therapy.与既往内分泌治疗进展的晚期/转移性乳腺癌患者临床试验结果相比,哌柏西利的真实世界有效性。
Breast Cancer (Auckl). 2019 Jan 10;13:1178223418823238. doi: 10.1177/1178223418823238. eCollection 2019.
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Palbociclib plus letrozole as first-line therapy in estrogen receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer with extended follow-up.帕博西尼联合来曲唑作为雌激素受体阳性/人表皮生长因子受体 2 阴性晚期乳腺癌的一线治疗,随访时间延长。
Breast Cancer Res Treat. 2019 Apr;174(3):719-729. doi: 10.1007/s10549-018-05125-4. Epub 2019 Jan 10.
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Palbociclib plus endocrine therapy in HER2 negative, hormonal receptor-positive, advanced breast cancer: A real-world experience.帕博西尼联合内分泌治疗激素受体阳性、HER2 阴性晚期乳腺癌:真实世界经验。
J Cell Physiol. 2019 Jun;234(6):7708-7717. doi: 10.1002/jcp.27832. Epub 2018 Dec 10.
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Palbociclib in combination with letrozole in patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer: PALOMA-2 subgroup analysis of Japanese patients.来曲唑联合帕博西尼治疗雌激素受体阳性、人表皮生长因子受体 2 阴性的晚期乳腺癌患者:来自 PALOMA-2 研究的日本患者亚组分析。
Int J Clin Oncol. 2019 Mar;24(3):274-287. doi: 10.1007/s10147-018-1353-9. Epub 2018 Dec 4.