拉帕替尼治疗HER-2阳性转移性乳腺癌的临床效果  

Clinical effect of lapatinib in the treatment of metastatic breast cancer with positive HER-2

作　　者：曾加佳 董洁[1] 邓志红[1] 黄蕴 ZENG Jiajia;DONG Jie;DENG Zhihong;HUANG Yun(Breast Surgery Department,Guilin Hospital of Traditional Chinese Medicine,Guilin 541002,China)

机构地区：[1]桂林市中医医院乳腺外科,广西桂林541002

出　　处：《临床医学研究与实践》2021年第25期67-69,共3页Clinical Research and Practice

摘　　要：目的探讨拉帕替尼治疗HER-2阳性转移性乳腺癌的临床效果。方法回顾性分析2019年1月至2020年4月收治的25例经多线治疗后进展的HER-2阳性转移性乳腺癌患者的临床资料。拉帕替尼口服剂量为1250 mg,根据患者不良反应及PS评分进行剂量调整。评估患者的近、远期疗效,分析影响患者预后的因素,并统计不良反应发生情况。结果25例患者的中位PFS为6.0个月(5.0~6.7个月)。CR 1例,PR 14例,SD 8例,PD 2例。ORR为60.00%(15/25),DCR为92.00%(23/25)。单因素分析结果显示,HR受体情况、单双靶方案与拉帕替尼治疗的PFS有关(P<0.05)。多因素Cox比例风险模型分析结果显示,HR受体情况、单双靶方案是影响PFS的独立危险因素(P<0.05)。患者的主要不良反应是腹泻、恶心呕吐、手足综合征、口腔炎等,多为1、2级,3级不良反应为腹泻4例(16.00%),手足综合征1例(4.00%)。结论曲妥珠单抗一线治疗失败后,在化疗联合曲妥珠单抗基础上加用拉帕替尼对比单靶治疗,能显著延长HER-2阳性转移性乳腺癌患者的中位PFS,且不良反应可控,是一线治疗失败后的选择之一。Objective To investigate the clinical effect of lapatinib in the treatment of metastatic breast cancer with positive HER-2.Methods Clinical data of 25 patients with metastatic breast cancer with HER-2 positive progression after multiline therapy admitted from January 2019 to April 2020 were retrospectively analyzed.The oral dose of lapatinib was 1250 mg,and the dose was adjusted according to patients'adverse reactions and PS score.The short and long term effect of the patients were evaluated,the factors affecting the prognosis of the patients were analyzed,and the occurrence of adverse reactions was statistically analyzed.Results The median PFS of 25 patients was 6.0 months(5.0-6.7 months).There were 1 cases of CR,14 cases of PR,8 cases of SD and 2 cases of PD.ORR was 60.00%(15/25)and DCR was 92.00%(23/25).The results of univariate analysis showed that the HR receptor status and single-double-target regimen were related to the PFS of lapatinib treatment(P<0.05).Multivariate Cox proportional risk model analysis result showed that HR receptor status and single-double-target regimen were independent risk factors affecting PFS(P<0.05).The main adverse reactions of patients were diarrhea,nausea and vomiting,hand-foot syndrome,stomatitis,etc.,most of them were grade 1 and 2,and grade 3 adverse reactions were diarrhea in 4 cases(16.00%)and hand-foot syndrome in 1 case(4.00%).Conclusion After the failure of trastuzumab first-line treatment,plus lapatinib on the basis of the chemotherapy combined with trastuzumab can significantly prolong the median PFS of metastatic breast cancer patients with positive HER-2 compared with single target therapy,and has controllable adverse reactions,so it is one of the options after the failure of first-line treatment.

关 键 词：HER-2阳性转移性乳腺癌 拉帕替尼 预后 

分 类 号：R737.9[医药卫生—肿瘤]