氟维司群联合曲妥珠单抗治疗芳香化酶抑制剂耐药的晚期Luminal B型(HER-2阳性)乳腺癌的疗效观察

Combination of fulvestrant and trastuzumab for the treatment of Luminal B( HER-2 positive) advanced breast cancers after prior aromatase inhibitors

目的观察芳香化酶抑制剂耐药的晚期Luminal B型(HER-2阳性)乳腺癌患者化疗临床获益后,行氟维司群联合曲妥珠单抗维持治疗的疗效及不良反应。方法 11例芳香化酶抑制剂耐药的晚期Luminal B型(HER-2阳性)乳腺癌患者化疗临床获益后,接受氟维司群内分泌治疗联合曲妥珠单抗靶向治疗维持。氟维司群500mg肌肉注射,每月1次,第1个月的第14天加用500mg肌肉注射1次。曲妥珠单抗6mg/kg静滴,每3周重复。结果所有患者均可评价疗效,其中CR 1例,PR 1例,SD 5例,有效率(RR)为18.2%,疾病控制率(DCR)为63.6%。平均无疾病进展生存时间为8.4个月。毒副反应轻微,多为1～2级,无3级以上不良反应。结论芳香化酶抑制剂耐药的晚期Luminal B型(HER-2阳性)乳腺癌患者,化疗有效后可行氟维司群内分泌治疗联合曲妥珠单抗靶向维持治疗,可延长其无疾病进展生存时间。

Objective To observe the efficacy and safety of Luminal B（ HER-2 positive） advanced breast cancer patients who receive fulvestrant combined with trastuzumab after prior aromatase inhibitors and disease controlled by chemotherapy. Methods There were 11 advanced aromatase inhibitors Luminal B breast cancer patients who received fulvestrant plus trastuzumab as maintenane therapy,after they benefited from palliative chemotherapy. Fulvestrant regimen was 500 mg every month plus 500 mg on day 14 of month 1 and trastuzumab regimen was 6mg /kg every 3 weeks. Results All patients were available for evaluation. Of the 11 patients,1 case got complete response（ CR）,1 case had partial response（ PR） and 5 cases had stable disease（ SD）. The average PFS was 8. 4months. The objective response rate was 18. 2% and disease control rate was 63. 6%. The treatment was well tolerated and no severe adverse effects were observed. Conclusion The combination of fulvestrant and trastuzumab regimen is effective and tolerable in the treatment of advanced Luminal B（ HER-2 positive） breast cancer patients who resistant to aromatase inhibitors after palliative chemotherapy to prolong the progression-free survival time.