Etikasari Ria, Andayani Tri Murti, Endarti Dwi, Taroeno-Hariadi Kartika Widayati
Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Int J Hematol Oncol Stem Cell Res. 2023 Jan 1;17(1):48-55. doi: 10.18502/ijhoscr.v17i1.11713.
Several studies showed the superiority of aromatase inhibitor (AI) as first-line therapy for patients with hormone-receptor (HR)-positive breast cancer (BC). For the clinician, studies in the real world are warranted to determine treatment based on the efficacy of each drug. We compared a 5-y disease-free survival (DFS) of each AI in terms of survival benefit. We evaluated 450 medical records of postmenopausal women who were diagnosed with HR-positive HER2-negative BC (stage I - III) at Dr. Sardjito General Hospital from January to December 2019. All patients had undergone surgery and chemotherapy or radiation therapy. Moreover, study participants received anastrozole, letrozole, or exemestane for at least one year. Kaplan Meier estimation survival curve was used to analyze the survival rate. Of 79 patients meeting inclusion criteria, there were 21.52% distant metastases documented. Time to disease progression of anastrozole, letrozole, and exemestane was 49 months, 58 months, and 53 months, respectively. Letrozole was found better than anastrozole (hazard ratio (HR)=4.342, 95% CI 0.95-19.95; p=0.038). Letrozole versus exemestane (HR=2.757, 95% CI 0.53-14.33; p=0,206) and anastrozole versus exemestane (HR=1.652, 95% CI 0.56-4.84; p=0.351) were found not significantly different. 5-y DFS rate of letrozole was better found (87.5%) than exemestane (73.7%) and anastrozole (61.4%). 5-year letrozole administration could be proposed as first-line therapy for postmenopausal women with HR-positive HER2-negative BC. A considerable subject and long-term follow-up are needed for validation.
多项研究表明，芳香化酶抑制剂（AI）作为激素受体（HR）阳性乳腺癌（BC）患者的一线治疗具有优越性。对于临床医生而言，有必要开展真实世界研究，以便根据每种药物的疗效来确定治疗方案。我们比较了每种AI在生存获益方面的5年无病生存期（DFS）。我们评估了2019年1月至12月在萨迪托综合医院被诊断为HR阳性、人表皮生长因子受体2（HER2）阴性BC（I - III期）的450名绝经后女性的病历。所有患者均接受了手术以及化疗或放疗。此外，研究参与者接受阿那曲唑、来曲唑或依西美坦治疗至少一年。采用Kaplan Meier估计生存曲线分析生存率。在符合纳入标准的79名患者中，有21.52%记录有远处转移。阿那曲唑、来曲唑和依西美坦的疾病进展时间分别为49个月、58个月和53个月。发现来曲唑优于阿那曲唑（风险比（HR）=4.342，95%置信区间0.95 - 19.95；p = 0.038）。来曲唑与依西美坦（HR = 2.757，95%置信区间0.53 - 14.33；p = 0.206）以及阿那曲唑与依西美坦（HR = 1.652，95%置信区间0.56 - 4.84；p = 0.351）之间未发现显著差异。发现来曲唑的5年DFS率（87.5%）优于依西美坦（73.7%）和阿那曲唑（61.4%）。对于HR阳性、HER2阴性的绝经后BC女性，可建议将5年来曲唑给药作为一线治疗方案。需要大量受试者并进行长期随访以进行验证。
