Hortobagyi G N
Department of Breast and Gynecologic Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, 77030, USA.
Semin Oncol. 1995 Apr;22(2 Suppl 5):80-6; discussion 86-7.
Metastatic breast cancer is treated with sequential hormone therapy for hormone-sensitive subgroups of patients, and combination chemotherapy for hormone-refractory tumors. The judicious utilization of both hormonal therapy and chemotherapy results in palliation for the majority of patients with this disease. In recent years, several new, exciting cytotoxic agents have reached clinical development. Among these is vinorelbine (Navelbine; Burroughs Wellcome Co, Research Triangle Park, NC; Pierre Fabre Medicament, Paris, France), a new vinca alkaloid clearly of great interest. Vinorelbine administered as a single agent following the weekly intravenous route of administration resulted in major objective responses in 45% of patients. Even in patients previously exposed to standard chemotherapy, 20% to 30% achieved a major objective regression. Front-line chemotherapy with vinorelbine associated with an anthracycline or 5-fluorouracil resulted in remission rates and durations, as well as survival times, comparable to those achieved with standard combinations. Combinations containing vinorelbine are being introduced in the adjuvant and neoadjuvant settings. Furthermore, additional schedules of administration of vinorelbine are being explored, including dose intensification in single-agent and combination trials. Vinorelbine is an effective agent for the treatment of metastatic breast cancer, and represents a welcome addition to our treatment armamentarium.
转移性乳腺癌针对激素敏感亚组患者采用序贯激素疗法治疗，针对激素难治性肿瘤采用联合化疗。明智地运用激素疗法和化疗可使大多数此类疾病患者病情得到缓解。近年来，几种令人振奋的新型细胞毒性药物已进入临床研发阶段。其中包括长春瑞滨（诺维本；百时美施贵宝公司，北卡罗来纳州三角研究园；法国巴黎皮尔法伯制药公司），这是一种显然备受关注的新型长春花生物碱。每周静脉注射一次长春瑞滨单药治疗，45%的患者出现主要客观反应。即使是先前接受过标准化疗的患者，也有20%至30%实现了主要客观缓解。长春瑞滨与蒽环类药物或5-氟尿嘧啶联合进行一线化疗，其缓解率、缓解持续时间以及生存时间与标准联合方案相当。含长春瑞滨的联合方案正被引入辅助和新辅助治疗中。此外，正在探索长春瑞滨的其他给药方案，包括单药和联合试验中的剂量强化。长春瑞滨是治疗转移性乳腺癌的有效药物，是我们治疗手段中的一个受欢迎的补充。
