Department of Breast, Bone & Soft Tissue Oncology, Guangxi Medical University Cancer Hospital, Nanning, China.
Ann Palliat Med. 2021 Dec;10(12):12101-12112. doi: 10.21037/apm-21-2624.
This study aimed to prospectively evaluate and investigate the efficacy and safety of recombinant human endostatin (Rh-endostatin) combined with platinum-based regimens for advanced triple-negative breast cancer (TNBC) patients.
This study was a prospective, single-arm, single-center, open-label trial. From January 2017 to August 2019, 21 women aged 18-70 years with histologically confirmed advanced TNBC were enrolled. Rh-endostatin at 30 mg/d was continuously pumped for 7 days and used synchronously with the chemotherapy cycle. The primary endpoint of this study was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), clinical benefit rate (CBR), overall survival (OS), and toxicity.
The median PFS (mPFS) was 8.8 months (95% CI: 7.2-10.4 months), and the median OS was 13.3 months (95% CI: 11.6-15.0 months). The ORR and CBR for the whole population were 47.6% and 52.4%, respectively. Patients sensitive to anthracycline and taxane drugs showed a significantly longer mPFS compared to those who were resistant to anthracycline and taxane drugs (mPFS: 8.8 vs. 5.3 months, P=0.038). For patients who received first- and second-line therapy or beyond, the mPFS was 8.8 and 5.3 months, respectively, with a significant difference (P=0.025). No statistically significant differences in the mPFS between pemetrexed combined with platinum and gemcitabine/taxanes combined with platinum were observed. The most common grade 3-4 hematologic toxicities were neutropenia (14.3%) and anemia (14.3%). One patient (4.8%) experienced febrile neutropenia. No grade 3-4 non-hematologic toxicities were observed, and no treatment-related deaths were reported in this study.
This study revealed that Rh-endostatin might enhance the antitumor effects of platinum-based chemotherapy for advanced TNBC patients with well-tolerated toxicities, which may provide a new basis and novel idea for the treatment of TNBC. However, further investigations and validation of its long-term efficacy and toxicity are warranted in the future.
本研究旨在前瞻性评估和研究重组人血管内皮抑制素(rh-endostatin)联合铂类方案治疗晚期三阴性乳腺癌(TNBC)患者的疗效和安全性。
这是一项前瞻性、单臂、单中心、开放标签的临床试验。2017 年 1 月至 2019 年 8 月,共纳入 21 例组织学确诊为晚期 TNBC 的年龄在 18-70 岁的女性患者。rh-endostatin 以 30mg/d 的剂量连续泵注 7 天,并与化疗周期同步使用。该研究的主要终点是无进展生存期(PFS)。次要终点包括客观缓解率(ORR)、疾病控制率(DCR)、临床获益率(CBR)、总生存期(OS)和毒性。
中位 PFS(mPFS)为 8.8 个月(95%CI:7.2-10.4 个月),中位 OS 为 13.3 个月(95%CI:11.6-15.0 个月)。全人群的 ORR 和 CBR 分别为 47.6%和 52.4%。对蒽环类和紫杉类药物敏感的患者的 mPFS 明显长于对蒽环类和紫杉类药物耐药的患者(mPFS:8.8 与 5.3 个月,P=0.038)。接受一线及二线以上治疗的患者 mPFS 分别为 8.8 和 5.3 个月,差异有统计学意义(P=0.025)。培美曲塞联合铂类与吉西他滨/紫杉烷联合铂类药物的 mPFS 无统计学差异。最常见的 3-4 级血液学毒性是中性粒细胞减少症(14.3%)和贫血(14.3%)。1 例患者(4.8%)发生发热性中性粒细胞减少症。未观察到 3-4 级非血液学毒性,本研究未报告与治疗相关的死亡。
本研究表明,rh-endostatin 可能增强铂类化疗治疗晚期 TNBC 患者的抗肿瘤作用,且毒性可耐受,这可能为 TNBC 的治疗提供新的依据和新的思路。然而,未来仍需要进一步研究和验证其长期疗效和毒性。