贝伐单抗联合多西他赛和卡培他滨二线治疗转移性三阴性乳腺癌的临床研究

The clinical study of bevacizumab combination with docetaxel-capecitabine in the second-line treatment of advanced triple-negative breast cancer

目的：回顾性分析贝伐单抗联合多西他赛和卡培他滨二线治疗三阴性乳腺癌的临床疗效及安全性。方法：转移性三阴性乳腺癌女性患者均经病理证实,患者至少存在一个可行RECIST1.1评估的病灶,既往使用过蒽环类、紫杉醇或吉西他滨等一线化疗,其中接受过紫杉类治疗的间隔一年以上。贝伐单抗15mg/kg,多西他赛75mg/m2,卡培他滨1.5口服2次/d,1~14d,3周重复。每个患者至少接受两个周期的化疗,每个周期后评估毒副反应,每两个周期后评价疗效,按RECIST1.1标准分为完全缓解（RR）,部分缓解（（PR）,稳定（SD）和进展（PD）,其中疾病控制率（DCR）=RR＋PR＋SD。结果：20例三阴性乳腺癌患者入组,没有观察到RR的病例,PR为50%（n=10）,SD为25%（n=5）,PD 25%（n=5）,DCR为75%。主要的毒副反应是骨髓抑制,其中Ⅲ/Ⅳ级中粒细胞减少15例（75%）,粒细胞减少性发热2例（10%）;1级高血压2例,2级高血压1例（15%）;2级蛋白尿1例（5%）;1级口腔黏膜出血1例（5%）,没有观察到消化道穿孔、中枢神经系统出血等严重并发症。结论：贝伐单抗联合多西他赛和卡培他滨二线治疗转移性三阴性乳腺癌可获得较好疗效且毒副反应可耐受。

Aim To evaluated the effectiveness and safety of bevacizumab combination with docetaxel - capecitabine in the second - line treatment of advanced triple- negative breast cancer （TNBC） . Methods： Women with metastatic breast cancer, estrogen/progesterone- receptor （ER/PR） and human epidermal growth factor receptor 2 （HER2） negative, confiemed by pathology, previously used anthracycline, taxane or gemcitabine as first - line chemothrapy, received at least two cycles of 1 5 mg/kg bevacizumab, 7 5 mg/m2docetaxel and capecitabine 1.5 twice every day for 14 days every 21 days. Results： Twenty patients were recruited from Wu Xi Peo- ple＇ s Hospital. The median age was 50 years old （range 28 -70） . No complete response occurred , clinical partial response 50% （n = 10） ; stable disease 25% （n = 5） and progression of the disease 25% （ n =5）, The disease control rate （DCR） was 75% . Most frequent adverse events were neutropenia 75% （n =15）, and febrile neutropenia 10% （ n = 2）, grade 1 hypertension and grade 2 hypertension 15% （ n =3）, grade 2 proteinuria 5% （ n = 1 ）, grade 1 oral mucosal bleeding 5% （ n = 1 ） . Conclusions： Bevacizumab, docetaxel and capecitabine was an effective and well - tolerated second - hne therapy in patients with advanced triple - negative breast cancer.