晚期乳腺叶状肿瘤的全身治疗：一项多机构欧洲回顾性病例系列分析。
Systemic treatment in advanced phyllodes tumor of the breast: a multi-institutional European retrospective case-series analyses.
机构信息
Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Department of Ambulatory Cancer Care, Sarcoma Group, Gustave Roussy, Villejuif, France.
出版信息
Breast Cancer Res Treat. 2022 Apr;192(3):603-610. doi: 10.1007/s10549-022-06524-4. Epub 2022 Feb 12.
BACKGROUND
We aimed at investigating outcome of systemic treatments in advanced breast PT.
METHODS
All cases of advanced breast PT treated with systemic treatments from 1999 to 2019, in one of the referral sarcoma centers involved in the study, were retrospectively reviewed.
RESULTS
56 female patients were identified. Median age was 52 (range of 25-76) years. Patients received a median number of 2 systemic treatments (range of 1-4). Best responses according to RECIST were 1 (3.7%) CR, 11 (40.7%) PR, 6 (22.2%) SD, 9 (33.3%) PD with anthracyclines plus ifosfamide (AI); 2 (16.7%) PR, 4 (33.3%) SD, 6 (50.0%) PD with anthracycline alone; 3 (18.8%) PR, 4 (25.0%) SD, 9 (56.3%) PD with high-dose ifosfamide given as a continuous infusion (HD-IFX); 3 (20.0%) SD, 12 (80.0%) PD with a gemcitabine-based regimen (with 2 patients not evaluable); 1 (8.3%) PR, 2 (16.7%) SD, 9 (75.0%) PD with trabectedin (with 1 patient not evaluable); 1 (16.7%) PR, 1 (16.7%) SD, 4 (66.7%) PD with tyrosine-kinase inhibitors (TKI). The median PFS were 5.7 (IQR 2.5-9.1) months with AI; 3.2 (IQR 2.2-5.0) months with anthracycline alone; 3.4 (IQR 1.4-6.7) months with HD-IFX; 2.1 (IQR 1.4-5.2) months with gemcitabine-based chemotherapy; 1.8 (IQR 0.7-6.6) months with trabectedin; 3.4 (IQR 3.1-3.8) months with TKI. With a median follow-up of 35.3 (IQR 17.6-66.9) months, OS from the start of first-line systemic treatment was 15.2 (IQR 7.6-39.6) months.
CONCLUSION
In this series of advanced PT (to our knowledge, the largest reported so far), AI was associated with a high rate of responses, however, with a median PFS of 5.7 months. Other systemic treatments were poorly active.
背景
我们旨在研究晚期乳腺派杰氏病（PT）的全身治疗结果。
方法
回顾性分析了 1999 年至 2019 年间在参与研究的转诊肉瘤中心之一接受全身治疗的所有晚期乳腺 PT 病例。
结果
共确定了 56 名女性患者。中位年龄为 52 岁（25-76 岁）。患者接受的系统治疗中位数为 2 种（1-4 种）。根据 RECIST，最佳反应为 1 例（3.7%）完全缓解（CR），11 例（40.7%）部分缓解（PR），6 例（22.2%）疾病稳定（SD），9 例（33.3%）疾病进展（PD），接受蒽环类药物加异环磷酰胺（AI）治疗；2 例（16.7%）PR，4 例（33.3%）SD，6 例（50.0%）PD，接受单独蒽环类药物治疗；3 例（18.8%）PR，4 例（25.0%）SD，9 例（56.3%）接受高剂量异环磷酰胺连续输注（HD-IFX）治疗；3 例（20.0%）SD，12 例（80.0%）PD，接受吉西他滨为基础的方案治疗（2 例无法评估）；1 例（8.3%）PR，2 例（16.7%）SD，9 例（75.0%）PD，接受 trabectedin 治疗（1 例无法评估）；1 例（16.7%）PR，1 例（16.7%）SD，4 例（66.7%）PD，接受酪氨酸激酶抑制剂（TKI）治疗。AI 组的中位无进展生存期（PFS）为 5.7（IQR 2.5-9.1）个月；单独使用蒽环类药物的中位 PFS 为 3.2（IQR 2.2-5.0）个月；HD-IFX 组为 3.4（IQR 1.4-6.7）个月；吉西他滨为基础的化疗组为 2.1（IQR 1.4-5.2）个月；trabectedin 组为 1.8（IQR 0.7-6.6）个月；TKI 组为 3.4（IQR 3.1-3.8）个月。中位随访 35.3（IQR 17.6-66.9）个月，从一线全身治疗开始的总生存期（OS）为 15.2（IQR 7.6-39.6）个月。
结论
在本系列晚期 PT 病例中（据我们所知，这是迄今为止报道的最大系列），AI 治疗的反应率较高，但中位 PFS 为 5.7 个月。其他全身治疗效果较差。
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