阿帕替尼治疗多线治疗失败后晚期乳腺癌的疗效及预后临床研究

Efficacy and prognosis of apatinib in patients with heavily pretreated advanced breast cancer

目的观察甲磺酸阿帕替尼单药治疗多线治疗失败的晩期乳腺癌的疗效及安全性。方法将30例经三线及以上治疗失败后接受甲磺酸阿帕替尼治疗的晚期乳腺癌患者作为治疗组,22例经三线及以上治疗失败后接受最佳支持治疗的晚期乳腺癌患者作为对照组,比较两组患者的疗效、不良反应及预后。结果治疗组患者总有效率及疾病控制率分别为36.7%(11/30)、86.7%(26/30),均高于对照组的4.5%(1/22)、45.5%(10/22),差异均有统计学意义(P﹤0.05)。治疗组患者在治疗过程中大多出现了1~2级不良反应,8例患者出现3级不良反应,2例患者出现4级不良反应,经对症治疗后均缓解,7例患者因不良反应减少用药剂量治疗,无患者因为不良反应而停药治疗。对照组患者的中位总生存期(OS)为6.8个月,短于治疗组的13.9个月,差异有统计学意义(P﹤0.05);对照组患者的中位无进展生存期(PFS)为3.6个月,短于治疗组的10.8个月,差异有统计学意义(P﹤0.05)。结论阿帕替尼治疗多线治疗失败的晚期乳腺癌患者近期疗效及预后好,不良反应可以耐受及控制,可在临床推广应用。

Objective To evaluate the efficacy and safety of apatinib mesylate in patients with heavily pretreated advanced breast cancer.Method A total of 30 patients with heavily pretreated advanced breast cancer who received treatment of apatinib were selected as the treatment group,22 patients with the same disease who received the best palliative care as control group.The efficacy,adverse reactions and prognosis were compared between the two groups.Result The overall response rate(ORR)and disease control rate(DCR)in the treatment group were higher than those in the control group[36.7%(11/30)vs 4.5%(1/22),86.7%(26/30)vs 45.5%(10/22);P<0.05].Grade 1-2 adverse reactions were commonly observed during treatment,and grade 3 and 4 adverse reactions were observed in 8 and 2 patients,respectively,all of which relieved after symptomatic treatment,with dose reduction in 7 patients and no discontinuation due to adverse reactions.Median overall survival(OS)and progression-free survival(PFS)in the control group were shorter than those in the treatment group(6.8 months vs 13.9 months,3.6 months vs 10.8 months;P<0.05).Conclusion The treatment of heavily pretreated advanced breast cancer with apatinib has better short term efficacy and prognosis,and the adverse reactions could be tolerated and controlled,which is worthy of clinical application.