Suppression of ovarian function in combination with an aromatase inhibitor as treatment for advanced breast cancer in pre-menopausal women
Suppression of ovarian function in combination with an aromatase inhibitor as treatment for advanced breast cancer in pre-menopausal women
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DOI：
10.1016/j.ejca.2010.08.005
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发表时间：
2010-11-01
影响因子：
8.4
通讯作者：
Winterbottom, L.
中科院分区：
文献类型：
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作者：
Cheung, K. L.;Agrawal, A.;Winterbottom, L.
试验表明，对于绝经后雌激素受体阳性晚期乳腺癌 (ER + ABC)，芳香酶抑制剂 (AI) 优于他莫昔芬。我们之前报道了使用戈舍瑞林加阿那曲唑 (G + A) 作为绝经前 ER + ABC 的二线内分泌治疗。我们报告了 G + A 作为一线全身治疗的临床和内分泌数据。36 名转移性乳腺癌患者（中位年龄 = 44 岁） (N = 28) 和局部晚期疾病接受 G + A 治疗 >= 6 个月（除非先前进展） 一些 (N = 13) 接受戈舍瑞林加另一种 AI（类固醇）、依西美坦 (G + E) 进一步治疗 进行了系列血清激素测定（雌二醇、脱氢表雄酮、硫酸睾酮、卵泡刺激素和黄体生成素） 24 名患者 (67%) 获得临床获益 (CB) （5% 完全缓解，31% 部分缓解，31% 疾病稳定 6 个月），中位进展时间和 CB 持续时间分别为 12 (2-47) 和 24 + (7-78+) 个月 10 名患者在分析时仍在接受一线 G + A 在继续接受 G + E 的 13 名患者中，38% 达到 CB，平均持续时间为 13+(7-32) 个月 治疗耐受性良好，无需停药G + A 导致雌二醇中位水平降低 98%（从治疗前到 6 个月）（从 574·5 pmol/L 四分位数范围 (IQR) = 209-1426 (N = 6) 降至 13·45 pmol/L IOQ = 5·5-31 5 (N = 4)，而其他激素水平在治疗期间波动最小。 AI 在绝经前 ER + ABC 中产生持续的 CB 和最小的副作用，并显着降低雌二醇水平 在非随机研究的限制内，应在激素敏感的适当患者中考虑使用它们 ABC (C) 2010 Elsevier Ltd 保留所有权利
Trials have shown superiority of aromatase inhibitors (AIs) over tamoxifen for post menopausal oestrogen receptor positive advanced breast cancer (ER + ABC) We previously reported the use of goserelin plus anastrozole (G + A) as second line endocrine therapy for pre menopausal ER + ABC We report clinical and endocrine data from G + A as first line systemic therapyThirty six patients (median age = 44 years) with metastatic (N = 28) and locally advanced disease were administered G + A for >= 6 months (unless progressed prior) Some (N = 13) received further therapy with goserelin plus another AI (steroidal), exemestane (G + E) Serial serum hormone assays (oestradiol dehydroepiandrosterone sulphate testosterone follicle stimulating hormone and luteinising hormone) were performedTwenty four patients (67%) derived clinical benefit (CB) (5% complete response 31% partial response 31% stable disease for 6 months) with median time to progression and duration of CB of 12 (2-47) and 24 + (7-78+) months respectively Ten patients were still receiving first line G + A at analysis Amongst 13 patients who went onto receive G + E 38% achieved CB with a mean duration of 13+(7-32) months Therapy was well tolerated with no withdrawalsThe combination of G + A resulted in 98% reduction (from pre treatment to 6 month) in median levels of oestradiol (from 574 5 pmol/L inter quartile range (IQR) = 209-1426 (N = 6) to 13 45 pmol/L IOQ = 5 5-31 5 (N = 4) whilst the levels of other hormones had minimal fluctuations during therapy The combinations of ovarian function suppression (using G) and AIs produce sus tamed CB and minimal side effects in pre menopausal ER + ABC with significant reduction in oestradiol levels Within the limitations of being a non randomised study they should be considered in appropriate patients with hormone sensitive ABC (C) 2010 Elsevier Ltd All rights reserved