培美曲塞联合顺铂治疗晚期三阴性乳腺癌的疗效观察

Observation on effect of pemetrexed combined with cisplatin on patients with advanced triple-negative breast cancer

目的 探讨培美曲塞联合顺铂治疗蒽环类和紫杉类化疗失败的晚期三阴性乳腺癌的疗效和不良反应.方法 选取已接受过蒽环类和紫杉类化疗的晚期三阴性乳腺癌患者23例,给予培美曲塞联合顺铂治疗：培美曲塞500 mg/m2 d1,顺铂25 mg/m2 d1 ～3,每21天为1周期,接受化疗至少2周期后评价疗效和不良反应.结果 23例患者均可评价疗效和不良反应；其中完全缓解2例（8.7％）,部分缓解7例（30.4％）,稳定9例（39.1％）,进展5例（21.8％）；有效率为39.1％；临床获益率为78.2％；中位疾病进展时间为6.5个月（3.9,9.1）；中位生存期为13.5个月（8.7,18.3）；主要不良反应为骨髓抑制和胃肠道反应,经对症处理后可缓解.结论 培美曲塞联合顺铂的治疗方案对紫杉类和蒽环类化疗失败的晚期三阴性乳腺癌具有较好的疗效和耐受性.

Objective To investigate efficacy and adverse effects of pemetrexed combined with cisplatin on patients with ad- vanced triple-negative breast cancer （TNBC） who failed in the treatment with anthracycline and taxane. Methods 23 patients with advanced TNBC who had received anthracycline and taxane were involved in the study. All patients were treated with pemetrexed （500mg/m2, i.v. dl） and cisplatin （25mg/m2, i.v. dl - 3） with a cycle of 21 days. The efficacy and adverse effects were evaluated after at least 2-cycle treatment （42 days）. Results Among the 23 patients, 2 cases （ 8.7% ） achieved CR, 7 cases （30.4%）got PR, 9 cases（39.1% ） were SD and 5 cases（21.7% ） had PD. The overall response rate （RR = CR ＋ PR） was 39.1% and the clinical benefit rate （ CR ＋ PR ＋ SD） was 78.2% ; The median time to progression （TFP） was 6.5 months （ 3.9, 9.1 ）, and the median over-all survival （OS） was 13.5 months （8.7,18.3）. The main adverse effects were myelosuppression and gastroenteric reaction which were alleviated after symptomatic treatment. Conclusion Pemetrexed combined with cisplatin is effective and well tolerated for patients with advanced TNBC after failure in the treatment with anthracycline and taxane.