Liu Chien-Ting, Hsieh Meng-Che, Su Yu-Li, Hung Chaio-Ming, Pei Sung-Nan, Liao Chun-Kai, Tsai Yu-Fen, Liao Hsiu-Yun, Liu Wei-Ching, Chiu Chong-Chi, Wu Shih-Chung, Wang Shih-Ho, Wei Ching-Ting, Rau Kun-Ming
Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
Chang Gung University, College of Medicine, Tao-Yuan 333, Taiwan.
J Cancer. 2021 Jul 3;12(17):5355-5364. doi: 10.7150/jca.60682. eCollection 2021.
Advanced breast cancer (ABC) has become a chronic disease. In such a situation, an effective therapy with low toxicities and economically acceptable is needed. Metronomic vinorelbine (mVNR) has been proved to be effective on the control of MBC. The aim of this study is to evaluate the efficacy and safety of mVNR as the salvage therapy for patients with ABC. Oral vinorelbine (VNR) was administered at 70 mg/m2, fractionated on days 1, 3, and 5, for 3 weeks on and 1 week off. Once the mVNR was combined with trastuzumab, or was combined with bevacizumab, the schedule was changed to 2 weeks on and 1 week off. Clinical data of patients with ABC who had received treatment with mVNR and tumor characteristics were collected and analyzed. From Mar. 2013 to Dec, 2020, there were 90 patients with ABC received mVNR. The overall response rate was 53.3% and overall disease control rate (DCR) was 78.9% in this study, including 4 (4.4%) cases reached complete response, 44 (48.9%) cases reached partial response and 23 (25.6%) cases were table disease. The median time to treatment failure (TTF) of the Lumina A patients was 13.3 months, Lumina B patients was 9.1 months, Her-2 enrich patients was 8.9 months, and triple negative breast cancer (TNBC) patients was 5.6 months. Median overall survival time for Lumina A, Lumina B, Her-2 enrich and TNBC were 54.6 months, 53.3 months, 59.5 months and 24.5 months separately. Side effects were minimal and manageable. Metronomic VNR can be an effective treatment for ABC either works as a switch maintenance or salvage therapy. In combination with target therapy or hormonal therapy, mVNR can further improve TTF and DCR with minimal toxicities. Further study should focus on the optimal dosage, schedule and combination regimen.
晚期乳腺癌（ABC）已成为一种慢性疾病。在这种情况下，需要一种毒性低且经济上可接受的有效治疗方法。节拍性长春瑞滨（mVNR）已被证明对转移性乳腺癌（MBC）的控制有效。本研究的目的是评估mVNR作为ABC患者挽救治疗的疗效和安全性。口服长春瑞滨（VNR）的剂量为70mg/m²，在第1、3和5天分次给药，持续3周，然后停药1周。一旦mVNR与曲妥珠单抗联合使用，或与贝伐单抗联合使用，给药方案改为持续2周，停药1周。收集并分析接受mVNR治疗的ABC患者的临床数据和肿瘤特征。2013年3月至2020年12月，有90例ABC患者接受了mVNR治疗。本研究中总缓解率为53.3%，总疾病控制率（DCR）为78.9%，其中4例（4.4%）达到完全缓解，44例（48.9%）达到部分缓解，23例（25.6%）病情稳定。Lumina A型患者的中位治疗失败时间（TTF）为13.3个月，Lumina B型患者为9.1个月，Her-2富集型患者为8.9个月，三阴性乳腺癌（TNBC）患者为5.6个月。Lumina A型、Lumina B型、Her-2富集型和TNBC的中位总生存时间分别为54.6个月、53.3个月、59.5个月和24.5个月。副作用轻微且可控。节拍性VNR作为转换维持治疗或挽救治疗对ABC可能是一种有效的治疗方法。与靶向治疗或激素治疗联合使用时，mVNR可以在毒性最小的情况下进一步提高TTF和DCR。进一步的研究应集中在最佳剂量、给药方案和联合治疗方案上。
