吡咯替尼联合化疗在人表皮生长因子受体-2阳性晚期乳腺癌一线及一线以上治疗中的应用效果  

Application effect of Pyrotinib combined with chemotherapy in first-line and above-first-line treatment of human epidermal growth factor receptor-2 positive advanced breast cancer

作　　者：郭玛丽 林丽平 丁晓芬 樊燕丹 GUO Mali;LIN Liping;DING Xiaofen;FAN Yandan(Department of Medical Oncology,Fujian Medical University Affiliated Sanming First Hospital,Fujian Province,Sanming365000,China)

机构地区：[1]福建医科大学附属三明第一医院肿瘤内科,福建三明365000

出　　处：《中国当代医药》2024年第7期114-118,共5页China Modern Medicine

摘　　要：目的探索吡咯替尼联合化疗在人表皮生长因子受体-2(HER-2)阳性晚期乳腺癌(ABC)一线或一线以上治疗中的应用效果。方法回顾性分析2020年3月至2023年5月福建医科大学附属三明第一医院收治的106例HER-2阳性ABC患者临床资料,依据治疗方法的不同分为对照组(53例)与观察组(53例),所有患者只需具有一个可测量病灶。对照组采用曲妥珠单抗+帕妥珠单抗+卡培他滨方案治疗,观察组采用吡咯替尼+卡培他滨方案治疗。比较两组的疾病控制率(DCR)及客观缓解率(ORR)、不良反应、肿瘤标志物水平[癌抗原153(CA153)、癌抗原199(CA199)及胸苷激酶1(TK1)]及生活质量。结果所有患者至少完成两个周期曲妥珠单抗+帕妥珠单抗+卡培他滨或吡咯替尼+卡培他滨治疗。两组ORR、DCR的比较,差异无统计学意义(P>0.05);两组不良反应包括腹泻、白细胞减少、恶心/呕吐、血小板减少、肝功能损害,不良反应发生率比较,差异无统计学意义(P>0.05);观察组治疗后的左室射血分数(LVEF)高于对照组,差异有统计学意义(P<0.05)。两组治疗后的CA153、CA199、TK1水平均低于治疗前,差异有统计学意义(P<0.05);两组治疗后的CA153、CA199、TK1水平比较,差异无统计学意义(P>0.05)。观察组治疗后的生活质量各指标评分高于对照组,差异有统计学意义(P<0.05)。结论吡咯替尼联合化疗在一线或一线以上药物治疗HER-2阳性ABC安全有效,能够降低心脏毒性,提高患者生活质量。Objective To explore the effect of Pyrotinib combined with chemotherapy in the first-line and above-first-line treatment of human epidermal growth factor receptor-2(HER-2)positive advanced breast cancer(ABC).Methods Clinical data of 106 patients with HER-2 positive ABC admitted to Fujian Medical University Affiliated Sanming First Hospital from March 2020 to May 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group(53 cases)and observation group(53 cases).All patients only had one measurable lesion.The control group was treated with Trastuzumab+Pertuzumab+Capecitabine regimen,and the observation group was treated with Pyrotinib+Capecitabine regimen.Disease control rate(DCR)and objective remission rate(ORR)efficacy,adverse reactions,tumor marker levels(cancer antigen 153[CA153],cancer antigen 199[CA199]and thymidine kinase 1[TK1])and quality of life were compared between the two groups.Results All patients completed at least two cycles of Trastuzumab+Pertuzumab+Capecitabine or Pyrotinib+Capecitabine treatment.There was no significant difference in ORR and DCR between the two groups(P>0.05).There were no significant differences in the incidence of adverse reactions,including diarrhea,leukopenia,nausea/vomiting,thrombocytopenia and liver function impairment between the two groups(P>0.05).The left ventricular ejection fraction(LVEF)of the observation group was higher than that of the control group after treatment,and the difference was statistically significant(P<0.05).The levels of CA153,CA199 and TK1 after treatment were lower than those before treatment,the differences were statistically significant(P<0.05).There was no significant difference in the levels of CA153,CA199 and TK1 between the two groups after treatment(P>0.05).The scores of each index of quality of life in the observation group after treatment were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Pyrotinib combined with chemotherapy

关 键 词：晚期乳腺癌 人表皮生长因子受体-2阳性 吡咯替尼 曲妥珠单抗 帕妥珠单抗 卡培他滨 肿瘤标志物 不良反应 

分 类 号：R737.9[医药卫生—肿瘤]