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HER2 阴性转移性乳腺癌患者队列中长时埃博霉素反应的预后因素。

Prognostic Factors for Long-Term Eribulin Response in a Cohort of Patients With HER2-Negative Metastatic Breast Cancer.

机构信息

Department of Medical Oncology, University Hospital of Besançon Jean-Minjoz, Besançon 25030, France.

Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon Jean-Minjoz, Besançon 25030, France; INSERM, Besançon 25020, France.

出版信息

Clin Breast Cancer. 2024 Oct;24(7):e622-e632.e5. doi: 10.1016/j.clbc.2024.06.006. Epub 2024 Jun 19.

Abstract

CONTEXT AND AIMS

Eribulin is used in taxane and anthracycline refractory HER2-negative metastatic breast cancers (MBC). Patients treated in pivotal clinical trials achieved low survival rates, therefore, the identification of prognostic criteria for long progression-free survival (PFS) is still an unmet medical need. In this study, we sought to determine potential prognostic criteria for long-term eribulin response in HER2-negative MBC.

METHODS

Our retrospective cohort includes female patients with HER2-negative MBC treated with eribulin in Franche-Comté, France. We defined a long-term response as at least 6 months of eribulin treatment. The primary endpoint was the analysis of criteria that differ according to the progression-free survival. Secondary outcomes concerned overall survival and response rate.

RESULTS

From January 2011 to April 2020, 431 patients treated with eribulin were screened. Of them, 374 patients were included. Median PFS was 3.2 months (2.8-3.7). Eighty-eight patients (23.5%) had a long-term response to eribulin. Four discriminant criteria allowed to separate PFS in 2 arms (PFS < 3 months or > 6 months) with a 78% positive predictive value: histological grade, absence of meningeal metastasis, response to prior chemotherapy, and OMS status. We have developed a nomogram combining these 4 criteria. Median overall survival was 8.5 months (7.0-9.5).

CONCLUSION

Eribulin response in MBC can be driven by clinical and biological factors. Application of our nomogram could assist in the prescription of eribulin.

摘要

背景和目的

艾立布林用于紫杉烷和蒽环类药物难治性 HER2 阴性转移性乳腺癌(MBC)。在关键性临床试验中接受治疗的患者生存率较低,因此,确定长无进展生存期(PFS)的预后标准仍然是未满足的医疗需求。在本研究中,我们旨在确定 HER2 阴性 MBC 患者长期接受艾立布林治疗的潜在预后标准。

方法

我们的回顾性队列纳入了在法国弗朗什孔泰接受艾立布林治疗的 HER2 阴性 MBC 女性患者。我们将长期反应定义为至少接受 6 个月的艾立布林治疗。主要终点是分析根据无进展生存期不同的标准。次要结局包括总生存期和缓解率。

结果

2011 年 1 月至 2020 年 4 月,筛选了 431 例接受艾立布林治疗的患者。其中,374 例患者被纳入研究。中位 PFS 为 3.2 个月(2.8-3.7)。88 例患者(23.5%)对艾立布林有长期反应。4 个判别标准可将 PFS 分为 2 组(PFS<3 个月或>6 个月),其阳性预测值为 78%:组织学分级、无脑膜转移、对既往化疗的反应和 OMS 状态。我们开发了一个包含这 4 个标准的列线图。中位总生存期为 8.5 个月(7.0-9.5)。

结论

MBC 中艾立布林的反应可由临床和生物学因素驱动。应用我们的列线图可以辅助艾立布林的处方。

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