Clinical outcomes and treatment practice patterns of patients with HER2-positive metastatic breast cancer in the post-trastuzumab era.
Clinical outcomes and treatment practice patterns of patients with HER2-positive metastatic breast cancer in the post-trastuzumab era.
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DOI：
10.1016/j.breast.2012.12.006
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发表时间：
2013-08
期刊：
影响因子：
3.9
通讯作者：
Lin, Nancy U.
中科院分区：
文献类型：
--
作者：
Olson, Erin M.;Najita, Julie S.;Sohl, Jessica;Arnaout, Amal;Burstein, Harold J.;Winer, Eric P.;Lin, Nancy U.
曲妥珠单抗与HER 2阳性转移性乳腺癌（MBC）患者的总生存期（OS）改善相关;然而，个体患者的病程和护理模式差异很大。回顾性确定了1999年至2005年期间接受基于曲妥珠单抗治疗的113例诊断为MBC的HER 2阳性患者，以允许至少5年的随访时间。使用Kaplan-Meier方法确定中位OS和中位治疗持续时间，组间比较基于对数秩检验。使用考克斯比例风险模型获得风险比（HR）。自转移性疾病首次治疗开始算起，中位OS为3.5年（95%CI 3.0-4.4）。在单变量分析中，与肝和/或肺转移或其他部位相比，中枢神经系统（CNS）疾病首次复发时的OS较短（CNS：1.9年CI 0.1-5.9，肝/肺：3.2年CI 2.5-4.2，其他：4.6年CI 2.7-8.0; p = 0.05），然而，在多变量分析中，这不能预测生存结果。到死亡或末次随访时，62例（55%）患者发生CNS转移。6线治疗的中位治疗持续时间相似，范围为5.2个月至7.2个月。HER 2阳性MBC的自然史随着基于曲妥珠单抗的治疗而演变，中位OS现在超过3年。CNS疾病是一个主要问题，随着时间的推移，CNS进展的风险持续存在。患者表现出多线HER 2导向治疗的临床获益。
Trastuzumab is associated with improvements in overall survival (OS) among patients with HER2-positive metastatic breast cancer (MBC); however disease course and patterns of care in individual patients are highly variable. 113 HER2-positive patients diagnosed with MBC from 1999 to 2005 who received trastuzumab-based therapy were retrospectively identified to allow for a minimum of 5 years of follow-up time. Median OS and median duration of therapy were determined using Kaplan–Meier methodology and group comparisons were based on the log-rank test. Hazard ratios (HR) were obtained using a Cox proportional hazards model. Median OS was 3.5 years (95% CI 3.0–4.4) from time of initiation of first therapy in the metastatic setting. On univariate analysis, central nervous system (CNS) disease at first recurrence was associated with a shorter OS compared with liver and/or lung metastases or other sites (CNS: 1.9 years CI 0.1–5.9, liver/lung: 3.2 years CI 2.5–4.2, other: 4.6 years CI 2.7–8.0; p = 0.05), however, this was not predictive of survival outcome in multivariate analysis. CNS metastases developed in 62 (55%) patients by the time of death or last follow-up. Median duration of therapy was similar up to 6 lines of treatment, and ranged from 5.2 months to 7.2 months. The natural history of HER2-positive MBC has evolved with trastuzumab-based therapy with median OS now exceeding 3 years. CNS disease is a major problem with continued risk of CNS progression over time. Patients demonstrate clinical benefit to multiple lines of HER2-directed therapy.
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影响因子：
8.4
作者：
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