Continuation of trastuzumab beyond disease progression is feasible and safe in patients with metastatic breast cancer: a retrospective analysis of 80 cases by the hellenic cooperative oncology group.
Continuation of trastuzumab beyond disease progression is feasible and safe in patients with metastatic breast cancer: a retrospective analysis of 80 cases by the hellenic cooperative oncology group.
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DOI：
10.3816/cbc.2003.n.017
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发表时间：
2003-06-01
影响因子：
3.1
通讯作者：
Skarlos, Dimosthenis
中科院分区：
文献类型：
--
作者：
Fountzilas, George;Razis, Evangelia;Skarlos, Dimosthenis
尽管曲妥珠单抗广泛用于治疗HER 2过表达转移性乳腺癌患者，但其最佳给药持续时间尚不清楚。我们回顾性分析了80例接受曲妥珠单抗单药治疗或联合化疗超过疾病进展的此类患者的病历，以登记其临床病程。患者的中位年龄为54岁。91%有3+ HER 2过表达，9%有2+ HER 2过表达。五十六%的患者以前接受过晚期疾病的化疗。一线和二线治疗中最常用的联合用药分别为曲妥珠单抗联合紫杉醇和曲妥珠单抗联合长春瑞滨。总共观察到32例缓解，其中大多数是在二线或三线治疗期间。常见的重度毒性（≥ 5%的患者）为中性粒细胞减少（25%）、血小板减少（11.5%）、感染（10%）、周围神经病变（9%）、恶心/呕吐（6%）、口腔炎（6%）、腹泻（6%）、便秘（6%）、水肿（6%）和肌痛/关节痛（5%）。诊断为晚期疾病后的中位生存期为43.4个月（范围，6.4-91.7+），而曲妥珠单抗给药后疾病进展后的中位生存期为22.2个月（范围，0.01-32.9+）。总之，这项回顾性分析表明，在HER 2过表达转移性乳腺癌患者中，在疾病进展后继续使用曲妥珠单抗是可行和安全的。随机研究是必要的。
Despite the widespread use of trastuzumab in the management of patients with HER2-overexpressing metastatic breast cancer, its optimal duration of administration is unknown. We retrospectively reviewed the medical records of 80 such patients who received trastuzumab monotherapy or combination chemotherapy beyond disease progression in order to register their clinical course. Median age of the patients was 54 years. Ninety-one percent had 3+ HER2 overexpression and 9% had 2+ HER2 overexpression. Fifty-six percent of patients had previously been treated with chemotherapy for advanced disease. The most commonly used combinations in first- and second-line treatments were trastuzumab with paclitaxel and trastuzumab with vinorelbine, respectively. In total, 32 responses were observed, most of them during the second or third line of treatment. Severe toxicities frequently seen (in = 5% of patients) were neutropenia (25%), thrombocytopenia (11.5%), infection (10%), peripheral neuropathy (9%), nausea/vomiting (6%), stomatitis (6%), diarrhea (6%), constipation (6%), edema (6%), and myalgias/arthralgias (5%). Median survival from diagnosis of advanced disease was 43.4 months (range, 6.4-91.7+), whereas median survival from disease progression after trastuzumab administration was 22.2 months (range, 0.01-32.9+). In conclusion, this retrospective analysis suggests that continuation of trastuzumab beyond disease progression in patients with HER2-overexpressing metastatic breast cancer is feasible and safe. Randomized studies are warranted.