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伊沙匹隆治疗转移性乳腺癌的疗效和耐受性评估。

Evaluation of ixabepilone efficacy and tolerability in metastatic breast cancer.

作者信息

Erciyestepe Mert, Ekinci Ömer Burak, Seçmeler Şaban, Selvi Oğuzhan, Öztürk Ahmet Emin, Aydin Okan, Büyükkuşcu Asli, Atasever Tugay, Çelik Emir, Ertürk Kayhan, Atci Muhammed Mustafa

机构信息

Department of Medical Oncology, Sağlik Bilimleri University, Prof. Dr. Cemil Taşcioğlu City Hospital, İstanbul, Turkey.

出版信息

Medicine (Baltimore). 2024 Nov 22;103(47):e40649. doi: 10.1097/MD.0000000000040649.

Abstract

Although microtubule inhibitors are generally used in advanced stages, they provide the opportunity to prolong survival as an alternative when medical oncologists have difficulty finding options in their patients, who typically have a poor prognosis and most of whom are unresponsive to treatment. For this reason, we wanted to investigate the effect of ixabepilone treatment on survival in earlier metastatic lines. Our study also examined the frequency of side effects and survival differences in patients whose dose was reduced or whose treatment was discontinued. Our study includes patients diagnosed with metastatic breast cancer who received ixabepilone treatment between January 2011 and January 2021. Median overall survival (OS) in the group receiving ixabepilone on the 5th line and before was 22.0 months (95% CI: 21.0-22.9), in the group receiving ixabepilone after the 5th line was calculated as 10.0 months (95% CI: 8.9-11.0) (P < .001). Median OS (months) in the group receiving ixabepilone on the 4th line and before was 26.0 (95% CI: 23.6-28.3), in the group receiving ixabepilone after the 4th line was determined as 12.0 (95% CI: 10.5-13.4) (P < .001). Dose reduction or discontinuation of ixabepilone treatment in patients due to side effects did not affect OS and progression-free survival with ixabepilone statistically significantly. Ixabepilone treatment has side effects, similar to all other treatments used in metastatic breast cancer, however, these side effects are manageable. Additionally, since ixabepilone treatment is preferred in patients who have previously received many different chemotherapeutics and experienced cumulative toxicity, the side effects of ixabepilone may seem to be greater than they are. In our study, we showed that ixabepilone treatment has a statistically significant positive effect on survival if preferred in earlier metastatic lines. As similar studies increase in centers where ixabepilone treatment is generally given in advanced metastatic lines, treatment approaches may change in the coming years.

摘要

尽管微管抑制剂通常用于晚期,但当医学肿瘤学家在他们的患者中难以找到治疗方案时,微管抑制剂为延长生存期提供了一种替代选择,这些患者通常预后较差,且大多数对治疗无反应。因此,我们想研究伊沙匹隆治疗对早期转移阶段患者生存期的影响。我们的研究还检查了剂量减少或治疗中断的患者的副作用发生频率和生存差异。我们的研究纳入了2011年1月至2021年1月期间接受伊沙匹隆治疗的转移性乳腺癌患者。接受伊沙匹隆治疗且处于第5线及之前的患者的中位总生存期(OS)为22.0个月(95%置信区间:21.0 - 22.9),接受伊沙匹隆治疗且处于第5线之后的患者的中位总生存期计算为10.0个月(95%置信区间:8.9 - 11.0)(P <.001)。接受伊沙匹隆治疗且处于第4线及之前的患者的中位总生存期(月)为26.0(95%置信区间:23.6 - 28.3),接受伊沙匹隆治疗且处于第4线之后的患者的中位总生存期确定为12.0(95%置信区间:10.5 - 13.4)(P <.001)。因副作用而减少伊沙匹隆剂量或中断治疗的患者,其总生存期和无进展生存期在统计学上无显著差异。伊沙匹隆治疗存在副作用,与转移性乳腺癌使用的所有其他治疗方法类似,然而,这些副作用是可控的。此外,由于伊沙匹隆治疗适用于先前接受过多种不同化疗并经历过累积毒性的患者,伊沙匹隆的副作用可能看起来比实际更大。在我们的研究中,我们表明,如果在早期转移阶段使用伊沙匹隆治疗,对生存期有统计学上的显著积极影响。随着在晚期转移阶段普遍使用伊沙匹隆治疗的中心开展的类似研究增多,未来几年治疗方法可能会发生变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cbd/11596583/144a31277e88/medi-103-e40649-g001.jpg

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