曲妥珠单抗结合帕妥珠单抗治疗HER2阳性乳腺癌的疗效及对血清miR-375 miR-30d表达变化的影响

Efficacy of Trastuzumab Combined with Pertuzumab in the Treatment of HER2-Positive Breast Cancer and Its Impact on Serum miR-375 and miR-30d Expression

目的:观察曲妥珠单抗联合帕妥珠单抗治疗人表皮生长因子受体-2(HER2)阳性乳腺癌的疗效及血清微RNA-375(miR-375)、微RNA-30 d(miR-30d)表达量变化的影响。方法:采用简单随机数字表及随机数余数分组法将2020年2月至2023年2月我院收治的139例HER2阳性乳腺癌患者分为联合组(n=70,曲妥珠单抗联合帕妥珠单抗治疗)与对照组(n=69,曲妥珠单抗治疗),每隔21d给药1次为1个疗程,共治疗4个疗程。比较两组临床疗效,比较治疗前、治疗后两组肿瘤相关指标[糖类抗原(CA125、CA153)、癌胚抗原(CEA)、循环肿瘤细胞(CTC)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、血清微RNA(miR-375、miR-30d)表达量及生活质量[癌症患者生命质量测定量表(QLQ-C30)]水平变化,并统计两组不良反应。结果:治疗期间两组均无患者死亡。联合组临床总有效率高于对照组(P<0.05);治疗后,两组血清CA125、CA153、CEA、CTC阳性率、CD8^(+)、miR-375、miR-30d表达量、QLQ-C30评分均低于治疗前(P<0.05),血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于治疗前,联合组各项指标差值均高于对照组(P<0.05);所有不良反应经对症处理后均缓解,联合组心悸发生率高于对照组(P<0.05)。结论:曲妥珠单抗联合帕妥珠单抗能有效提高HER2阳性乳腺癌患者免疫功能,降低肿瘤标志物水平及miR-375、miR-30d表达,改善生活质量,且安全性较高,临床疗效显著。

Objective:To observe the efficacy of combination of trastuzumab and pertuzumab in treating human epidermal growth factor receptor-2(HER2)-positive breast cancer and the effects on changes of expressions of serum microRNA-375(miR-375)and microRNA-30d(miR-30d).Methods:From February 2020 to February 2023,a total of 139 patients with HER2-positive breast cancer were randomly assigned to the combined group(n=70,receiving trastuzumab and pertuzumab)and the control group(n=69,receiving trastuzumab)using a simple random number table and random remainder grouping method.Each patient received one course of treatment every 21 days,and a total of four courses were administered.Clinical efficacy,tumor-related indicators(including carbohydrate antigens CA125 and CA153,carcinoembryonic antigen CEA,and circulating tumor cells CTC),T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),serum microRNA expression(miR-375 and miR-30d),and changes in quality of life(assessed using the Quality of Life Questionnaire-Cancer QLQ-C30)were compared between the two groups before and after treatment.Adverse reactions were also documented.Results:No patient died during the course of treatment in both groups.The total clinical effective rate was significantly higher in the combined group compared to the control group(P<0.05).After four courses of treatment,both groups exhibited reductions in serum CA125,CA153,CEA,CTC positive rate,CD8^(+)levels,and miR-375 and miR-30d expression,as well as improvements in QLQ-C30 scores compared to baseline(P<0.05).Additionally,serum CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)levels were elevated in both groups post-treatment compared to baseline,with the combined group displaying higher levels compared to the control group(P<0.05).Notably,the difference values of various indicators were significantly higher in the combined group compared to the control group(P<0.05).Adverse reactions were effectively managed,with a higher incidence of palpitations observed in the combined group(P<0.05).Conclusion:Trastuzumab combined with pertuzumab effectively enhances immune function,reduces tumor marker levels,modulates the expression of miR-375 and miR-30d,and improves the quality of life for HER2-positive breast cancer patients.Moreover,this treatment approach demonstrates a high safety profile and significant clinical efficacy.