氟维司群治疗曾接受过芳香化酶抑制剂治疗的复发转移性乳腺癌的临床研究  

Fulvestrant for the treatment of advanced breast cancer after prior aromatase inhibitor therapy

作　　者：姜航 王涛 张少华 杜萌 吴世凯 宋三泰 江泽飞 

机构地区：[1]解放军医学院,北京100853 [2]解放军三〇七医院乳腺肿瘤科,北京100071

出　　处：《中国癌症杂志》2013年第3期224-228,共5页China Oncology

摘　　要：背景与目的:内分泌治疗是激素受体阳性乳腺癌的标准治疗,随着芳香化酶抑制剂(aromataseinhibitors,AI)在临床上广泛使用,其治疗失败的后续治疗成为临床需要解决的问题。本研究旨在评价氟维司群解救治疗曾接受过AI治疗的复发转移性乳腺癌的临床疗效。方法:回顾性分析了56例氟维司群治疗AI耐药的复发转移性乳腺癌患者的临床资料,对临床疗效及其影响因素等进行统计分析。结果:全组患者中位年龄57岁。所有患者均为雌激素和(或)孕激素受体阳性,HER-2阳性率为10.7%。氟维司群的临床获益率为17.9%,客观缓解率为3.6%,中位PFS为3.0(1～17)个月。分为AI反应型和AI耐药型,两者的PFS及临床获益率(clinicalbenefit rates,CBR)差异无统计学意义(P=0.530,P=0.515)。单因素分析结果显示,术后腋窝淋巴结转移数目、无病生存时间、是否辅助内分泌治疗、总治疗线数、复发转移后转移灶数目是影响接受氟维司群治疗患者的PFS的因素,COX多因素分析显示,氟维司群PFS与无病生存时间、总治疗线数相关(P=0.017和P=0.021)。结论:氟维司群是AI治疗失败后可选择的重要治疗手段。Background and purpose： Endocrine therapy is a standard option in hormone receptor-positive breast cancer. With aromatase inhibitors （AI） being increasingly used as adjuvant and advanced therapy, it is important to identify subsequent treatment after AI failure. This study aimed to evaluate the efficacy of fulvestrant for advanced metastatic breast cancer following progression on AI. Methods： We analyzed retrospectively the records of 56 metastatic breast cancer patients who were resistant to AI and underwent fulvestrant therapy including clinical effects, influencing factors. Results： The patients＇ median age was 57. All the patients had ER-positive and/or PR-positive, and 6 patients （10.7%） were identified as having HER-2 positive disease. Ten patients （17.9%） experienced clinical benefit （CB）, overall response rate was 3.6%, median progression free survival （PFS） was 3.0 months （ranged 1-17 months）. Patients were categorized as AI sensitive and AI resistant, and progression free survival and clinical benefit of fulvestrant had no correlation （P=0.530, P=0.515）. Log-rank test showed that the PFS of fulvestrant had associated with lymph node metastatic status, disease free survival （DFS）, whether underwent adjuvant hormonal treatment, advanced treatment lines, the number of metastases, clinical benefit time of hormonal treatment. Cox regression showed that the PFS of fulvestrant had associated with DFS and treatment lines （P=0.017; P=0.021）. Conclusion： Fulvestrant was the important choice of treatment for the patients resistant to AI in metastatic breast cancer.

关 键 词：芳香化酶抑制剂耐药 激素依赖型 氟维司群 晚期乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]