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纳米白蛋白结合型紫杉醇单药治疗转移性乳腺癌的真实世界疗效

A Real-world Efficacy of Nab-paclitaxel Monotherapy in Metastatic Breast Cancer.

作者信息

Kim Jung Sun, Suh Koung Jin, Lee Dae-Won, Woo Go-Un, Kim Miso, Kim Se Hyun, Ryu Han Suk, Lee Kyung-Hun, Kim Tae-Yong, Han Sae-Won, Park So Yeon, Park In Ae, Kim Jee Hyun, Im Seock-Ah

机构信息

Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Cancer Res Treat. 2022 Apr;54(2):488-496. doi: 10.4143/crt.2021.394. Epub 2021 Aug 13.

Abstract

PURPOSE

We aimed to assess the real-world efficacy of nab-paclitaxel in metastatic breast cancer patients.

MATERIALS AND METHODS

This is a retrospective study performed in two tertiary referral hospitals in Korea. Patients with metastatic breast cancer treated with nab-paclitaxel (Abraxane®) between March 2016 and March 2020 were enrolled.

RESULTS

A total of 102 patients with metastatic breast cancer were included. Patients were heavily pre-treated with a median of four prior lines of chemotherapy (5 lines when including endocrine therapy in hormone-receptor-positive patients), and 66 patients (64.7%) were exposed to taxanes in the metastatic setting. According to St. Gallen molecular subtypes, 36 patients (35.3%) were luminal A, 28 (27.5%) were luminal B, 18 (17.7%) were human epidermal growth factor receptor 2-positive and 20 (19.6%) had triple-negative disease. Fifty patients (49.0%) were treated with a 3-weekly regimen (260 mg/m2 on day 1 every 3 weeks), and 52 (51.0%) were treated with a weekly regimen (100 mg/m2 every week). Objective response rate was 22.9%. After a median follow-up of 22.0 months, median progression-free survival (PFS) was 4.0 months (95% confidence interval [CI], 2.6 to 4.8) and median overall survival was 8.7 months (95% CI, 7.5 to 11.2). Patients treated with weekly regimen had longer PFS compared to 3-weekly regimen (5.5 vs. 2.3 months, p < 0.001). Multivariate analysis revealed the treatment regimen as an independent prognostic factor for PFS. There was no grade 3 or 4 hypersensitivity reaction.

CONCLUSION

This real-world data shows that nab-paclitaxel is a reasonable treatment option in heavily pre-treated and/or taxane-exposed metastatic breast cancer patients.

摘要

目的

我们旨在评估纳米白蛋白结合型紫杉醇在转移性乳腺癌患者中的实际疗效。

材料与方法

这是一项在韩国两家三级转诊医院进行的回顾性研究。纳入了2016年3月至2020年3月期间接受纳米白蛋白结合型紫杉醇(Abraxane®)治疗的转移性乳腺癌患者。

结果

共纳入102例转移性乳腺癌患者。患者此前接受过大量治疗,化疗的中位疗程为4个疗程(激素受体阳性患者若将内分泌治疗计算在内则为5个疗程),66例患者(64.7%)在转移情况下接受过紫杉烷类治疗。根据圣加仑分子亚型分类,36例患者(35.3%)为腔面A型,28例(27.5%)为腔面B型,18例(17.7%)为人表皮生长因子受体2阳性,20例(19.6%)为三阴性疾病。50例患者(49.0%)接受了每3周一次的治疗方案(每3周第1天给予260mg/m²),52例(51.0%)接受了每周一次的治疗方案(每周给予100mg/m²)。客观缓解率为22.9%。中位随访22.0个月后,中位无进展生存期(PFS)为4.0个月(95%置信区间[CI],2.6至4.8),中位总生存期为8.7个月(95%CI,7.5至11.2)。与每3周一次的治疗方案相比,接受每周一次治疗方案的患者PFS更长(5.5个月对2.3个月,p<0.001)。多变量分析显示治疗方案是PFS的独立预后因素。未出现3级或4级过敏反应。

结论

这些实际数据表明,纳米白蛋白结合型紫杉醇是经过大量前期治疗和/或接触过紫杉烷类的转移性乳腺癌患者的合理治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3954/9016319/0e214e87d8ec/crt-2021-394f1.jpg

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