Bajetta E, Zilembo N, Buzzoni R, Noberasco C, Celio L, Bichisao E
Division of Medical Oncology B, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
Cancer Treat Rev. 1993 Apr;19 Suppl B:31-6. doi: 10.1016/0305-7372(93)90005-c.
Aromatase inhibitors are known to be effective in the treatment of advanced postmenopausal breast cancer. To assess the efficacy of the aromatase inhibitor 4-hydroxyandrostenedione (4-OHA) as first-line treatment in patients who were either resistant to or had relapsed after adjuvant therapy, 50 eligible patients received intramuscular 4-OHA either 250 mg or 500 mg fortnightly until disease progression or severe adverse events. Of the 43 patients evaluable for clinical response (UICC criteria), 15 (36%) showed objective response (CR+PR), 6 (14%) stable disease (SD). In relation to disease site, objective responses were obtained in 55% of cases with soft tissue metastases (16/29); in 33% with visceral metastases (8/24), and in 24% with bone involvement (5/21). In relation to previous adjuvant treatment, there were eight objective responses among the 17 patients treated with chemotherapy (47%), and seven objective responses among the 24 treated with tamoxifen (29%). The treatment was well tolerated. These results support the hypothesis that adjuvant therapy, whether hormonal or chemotherapy, may make patients less responsive to subsequent treatment.
已知芳香化酶抑制剂在治疗晚期绝经后乳腺癌方面有效。为了评估芳香化酶抑制剂4-羟基雄烯二酮（4-OHA）作为一线治疗对辅助治疗耐药或复发患者的疗效，50例符合条件的患者每两周接受250毫克或500毫克的4-OHA肌肉注射，直至疾病进展或出现严重不良事件。在43例可评估临床反应（根据国际抗癌联盟标准）的患者中，15例（36%）显示客观反应（完全缓解+部分缓解），6例（14%）病情稳定（疾病稳定）。就疾病部位而言，55%的软组织转移患者（16/29）获得了客观反应；33%的内脏转移患者（8/24），以及24%的骨转移患者（5/21）。就先前的辅助治疗而言，接受化疗的17例患者中有8例获得客观反应（47%），接受他莫昔芬治疗的24例患者中有7例获得客观反应（29%）。该治疗耐受性良好。这些结果支持这样的假设，即辅助治疗，无论是激素治疗还是化疗，都可能使患者对后续治疗的反应性降低。
