吡咯替尼联合曲妥珠单抗治疗人表皮生长因子受体2阳性乳腺癌患者的效果

Effects of Pyrotinib combined with Trastuzumab in treatment of human epidermal growth factor receptor 2 positive breast cancer

目的:观察吡咯替尼联合曲妥珠单抗治疗人表皮生长因子受体2(HER2)阳性乳腺癌患者的效果。方法:选取2020—2022年该院收治的64例HER2阳性乳腺癌患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各32例。对照组采用曲妥珠单抗治疗,观察组在对照组基础上联合吡咯替尼治疗,比较两组临床疗效(疾病控制率、客观缓解率)、中位无进展生存期、总生存率,治疗前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)]、肿瘤标志物[癌胚抗原(CEA)、糖类抗原15-3(CA15-3)、血管内皮生长因子(VEGF)]水平,以及不良反应发生率。结果:观察组疾病控制率为93.75%(30/32),高于对照组的68.75%(22/32);观察组客观缓解率为78.12%(25/32),高于对照组的53.12%(17/32),差异均有统计学意义(P<0.05);观察组中位无进展生存期长于对照组,且总生存率为56.25%(18/32),高于对照组的25.00%(8/32),差异有统计学意义(P<0.05);治疗后,观察组TNF-α、IL-8、IL-1β水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组CEA、CA15-3、VEGF水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:吡咯替尼联合曲妥珠单抗治疗HER2阳性乳腺癌患者可提高疾病控制率、客观缓解率和总生存率,延长中位无进展生存期,降低炎性因子和肿瘤标志物水平,效果优于单纯曲妥珠单抗治疗。

Objective:To observe effects of Pyrotinib combined with Trastuzumab in treatment of patients with human epidermal growth factor receptor2(HER2)positive breast cancer.Methods:A prospective study was conducted on 64 patients with HER2 positive breast cancer admitted to the hospital from 2020 to 2022.According to the random number table method,they were divided into control group and observation group,32 cases in each group.The control group was treated with Trastuzumab,while the observation group was treated with Pyrotinib on the basis of that of the control group.The clinical efficacy(disease control rate,objective remission rate),the median progression-free survival,the overall survival rate,the levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),interleukin-1β(IL-1β)]and tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 15-3(CA15-3),vascular endothelial growth factor(VEGF)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The disease control rate of the observation group was 93.75%(30/32),which was higher than that of the control group(68.75%,22/32);the objective remission rate of the observation group was 78.12%(25/32),which was higher than that of the control group(53.12%,17/32);and the differences were statistically significant(P<0.05).The median progression-free survival of the observation group was longer than that of the control group;the overall survival rate was 56.25%(18/32),which was higher than 25.00%(8/32)of the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of TNF-α,IL-8 and IL-1βin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CEA,CA15-3 and VEGF in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Pyrotinib combined with Trastuzumab in the treatment of HER2 positive breast cancer can improve the disease control rate,the objective remission rate and the overall survival rate,prolong the median progression-free survival,and reduce the levels of inflammatory factors and tumor markers.Moreover,it is superior to simple Trastuzumab treatment.