摘要
目的探讨拉帕替尼耐药的人表皮生长因子受体2（HER-2）阳性晚期乳腺癌采用曲妥珠单抗治疗的临床疗效。方法选择含拉帕替尼联合方案一线治疗后进展的HER-2阳性晚期乳腺癌患者，根据二线治疗是否含有曲妥珠单抗将患者分为两组，一组为接受不含曲妥珠单抗的常规二线治疗（非曲妥珠单抗组，25例），另一组患者接受含曲妥珠单抗的联合方案二线治疗（曲妥珠单抗组，13例），分析两组患者的临床疗效。结果35例HER-2阳性晚期乳腺癌患者中，二线治疗未进展2例，均为曲妥珠单抗治疗患者；其余33例患者均在二线治疗中再次进展。因疾病进展而死亡27例，生存8例（曲妥珠单抗组6例，非曲妥珠单抗组2例）。曲妥珠单抗组与非曲妥珠单抗组患者的中位无进展生存时间（PFS）分别为10．0和3．3个月（P=0．001），中位总生存时间（OS）分别为31．1和7．0个月（P=0．015）。结论对于拉帕替尼耐药的HER-2阳性晚期乳腺癌，常规治疗基础上联合曲妥珠单抗可以进一步提高疗效。持续抗HER-2治疗能够为HER-2阳性乳腺癌患者带来生存获益。
Objective Retrospective and prospective studies have shown that continuous administration of trastuzumab with different chemotherapy regimens resulted in better clinical outcomes than the administration of chemotherapy alone in women with HER2-positive, trastuzumab-refractory metastatic breast cancer （MBC）. However, there are limited data to evaluate the activity of trastuzumab in patients progressed after other anti-HER2 therapies, e.g. lapatinib. The aim of the present study was to evaluate retrospectively the clinical value of trastuzumab in patients with lapatinib-resistant HER2-positive advanced breast cancer treated in our center. Methods Patients with HER2-positive MBC who experienced progression after first-line lapatinib-based regimens were assigned to receive either conventional treatment without trastuzumab or in combination with trastuzumab as second-line therapy. The efficacy end points included progression-free survival （PFS） and overall survival （OS）. Results Thirty-five eligible patients progressed after treatment with lapatinib-based regimens were collected. None of the patients had received prior trastuzumab in either the adjuvant or metastatic setting. Twenty-two patients were assigned to receive conventional treatment without trastuzumab as second-line therapy （non-T arm ） and 13 patients received conventional treatment combined with trastuzumab （T arm）. There were no significant differences in the main clinical factors between the two arms, such as age, PS status, ER/PR, metastatic status, etc. Both the two cases with no disease progression after the second-line therapy were trastuzumab-treated patients, and all the other 33 cases were patients with progression despite the second-line therapy. Twenty-seven patients died due to disease progression, and eight survived （ six cases of the T-arm and two cases of the non-T arm）. The median PFS was 3.3 months in the non-T arm and 10.0 months in the T arm （P =0.001）. The median OS was 7.0 months in the non-T arm and 31.1 months in the T arm （P =0.015）. Condusions Trastuzumab plus conventional treatment is superior to conventional treatment in women with lapatinib-resistant HER2-positive metastatic breast cancer. Continuous anti-HER2 management can provide survival benefit to patients with HER2-positive breast cancer.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2013年第7期521-524,共4页
Chinese Journal of Oncology
