曲妥珠单抗联合内分泌维持治疗HR和HER-2阳性晚期乳腺癌的临床观察  

Efficacy and toxicity of trastuzumab plus endocrine therapy as maintenance therapy hormone receptor-and HER-2-positive metastatic breast cancer

作　　者：张艳秋[1] 孙立柱[1] 王昳凡 王简[1] 殷咏梅[1] 

机构地区：[1]南京医科大学第一附属医院肿瘤科,南京210029

出　　处：《临床肿瘤学杂志》2017年第5期427-431,共5页Chinese Clinical Oncology

摘　　要：目的探讨曲妥珠单抗联合内分泌维持治疗激素受体(HR)和人表皮生长因子受体-2(HER-2)阳性复发转移性乳腺癌的疗效与安全性。方法回顾性分析本院2013年1月至2016年1月收治的HR和HER-2阳性复发转移性乳腺癌患者31例,一线曲妥珠单抗联合化疗达到病情缓解或稳定后继续曲妥珠单抗联合内分泌维持治疗,采用RECIST 1.1版标准评估维持治疗的疗效,采用常见不良反应事件评价标准(CTCAE)4.0版评价毒性反应,根据随访资料分析预后。结果 31例复发转移性乳腺癌维持治疗的中位无进展生存期为12.0个月(95%CI:5.4~18.6个月)。5例患者在一线化疗后获完全缓解,无可评估病灶,其余26例可评估近期疗效,总有效率和临床获益率分别为26.9%和88.5%。内分泌联合曲妥珠单抗的主要不良反应较轻,主要包括乏力(19.4%)、潮热(16.1%)和恶心呕吐(9.7%)。结论一线曲妥珠单抗联合化疗有效后,曲妥珠单抗联合内分泌维持治疗HR+/HER-2+转移性乳腺癌可进一步改善患者的临床获益,且安全性良好。Objective To evaluate the efficacy and toxicity of trastuzumab plus endocrine therapy as maintenance therapy after first-line chemotherapy plus trastuzumab for HR-positive and HER-2-positive metastatic breast cancer.Methods Patients with HR＋/HER-2＋ metastatic breast cancer receiving first-line chemotherapy and trastuzumab and sequentially continued endocrine therapy with ongoing trastuzumab as maintenance therapy were enrolled in this study.The clinical data was retrospeetively collected and efficacy and toxicity of the maintenance trastuzumab and endocrine therapy was analyzed.Response to maintenance therapy was assessed by RECIST criteria 1.1 and toxicity was evaluated according to Common Terminology Criteria for Adverse Events （CTCAE） v4.0.The prognosis was analyzed according to the follow-up data.Results Thirty-one patients were enrolled.The median progression-free survival of maintenance therapy was 12.0 months （95%CI： 5.4-18.6 months）.The maintenance regimen achieved response rate of 26.9% and disease control rate of 88.5%.The most common adverse events were mild, including fatigue （19.4%）, hot flashes （16.1%） and nausea and vomiting （9.7%）.Conclusion Adding maintenance endocrine therapy to ongoing trastuzumab upon the completion of first-line chemotherapy plus trastuzumab might improve clinical outcomes for HR＋/HER-2＋ metastatic breast cancer, and the regimen was well tolerated.

关 键 词：乳腺癌 维持治疗 曲妥珠单抗 化学治疗 内分泌治疗 

分 类 号：R737.9[医药卫生—肿瘤]