赫赛汀联合多西他赛或长春瑞滨治疗HER-2阳性转移性乳腺癌比较

Herceptin with either docetaxel or vinorelbine as salvage therapy for patients with HER-2 positive metastatic breast cancer: Comparative study

目的比较赫赛汀(Herceptin)联合多西他赛(docetaxel)与联合长春瑞滨(vinorelbine)治疗HER-2阳性的转移性乳腺癌的疗效。方法 HER-2阳性的转移性乳腺癌患者39例,赫赛汀的初始剂量为4 mg/kg,后2 mg/kg,1次/周,至少6周;多西他赛75mg/m2,静脉滴注,d2,每3周重复,共6周期;长春瑞滨25 mg/m2,静脉滴注,d1、d5,每3周重复,共6周期。结果赫赛汀联合多西他赛组的总有效率高于联合长春瑞滨组(78%vs 42%,P=0.027),而两组患者临床受益率(85%vs 58%,P=0.066)和中位肿瘤进展时间(12个月vs10个月,P=0.21)均无统计学差异。结论赫赛汀联合多西他赛方案的总有效率优于联合长春瑞滨方案,但赫赛汀联合长春瑞滨方案仍然因其较低的毒副作用及一定的有效率,可以作为治疗HER-2阳性的转移性乳腺癌的一线可选择方案。

Objective To evaluate the efficacy of Herceptin with docetaxel or vinorelbine as salvage therapy for patients with HER-2 positive metastatic breast cancer.Methods The 39 patients treated with either docetaxel or vinorelbine plus Herceptin received Herceptin at initial dose of 4 mg/kg,followed by weekly infusions at the dose of 2 mg/kg.Docetaxel was given at the dose of 75 mg/m2 on day 2,every 3 weeks.Vinorelbine was given at the dose of 25 mg/m2 on day 1,5,every 3 weeks.All the patients were treated with 6 cycles therapy at least.Results Herceptin-docetaxel was superior to Herceptin-vinorelbine in terms of response rate（RR： 78% vs 42%,P=0.027）,but not in clinical benefit rate（CBR： 85% vs 58%,P=0.066） and in median time to progression（TTP： 12 vs 10 months,P=0.21）.Conclusion Herceptin-docetaxel may offer some advantage in terms of reponse rate compared with Herceptin-vinorelbine.But Herceptin with vinorelbine is still an alternative therapy in treatment of HER-2 positive metastatic breast cancer because of its observed efficacy and less toxicity.