白蛋白紫杉醇联合曲妥珠单抗及帕妥珠单抗对人表皮生长因子受体2阳性乳腺癌患者的疗效

Effect of albumin paclitaxel combined with trastuzumab and pertuzumab in patients with human epidermal growth factor receptor 2-positive advanced breast cancer

目的:探讨白蛋白紫杉醇联合曲妥珠单抗及帕妥珠单抗治疗人表皮生长因子受体2(HER2)阳性的晚期乳腺癌(ABC)患者的疗效。方法:选取60例HER2阳性ABC患者为研究对象,根据不同治疗方式,将其分为对照组(n=30)和观察组(n=30)。对照组采用多西他赛联合曲妥珠单抗、帕妥珠单抗治疗;观察组采用白蛋白紫杉醇联合曲妥珠单抗、帕妥珠单抗治疗。两组患者均治疗6个周期(以21 d为1个周期)。比较两组患者临床疗效、生存期、肿瘤标志物水平和不良反应发生情况。结果:观察组客观有效率(ORR)、临床获益率(CBR)均高于对照组(P<0.05)。治疗后,两组患者糖类抗原(CA)15-3、癌胚抗原(CEA)、CA125水平均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者CA15-3、CEA水平差异均为高效应[95%CI:1.142(4.347~11.533)、1.485(1.900~3.941)],CA125水平差异为中效应[95%CI:0.670(0.652,5.048)]。观察组无进展生存期(PFS)、总生存期(OS)均高于照组(P<0.05);两组患者PFS、OS水平差异均为弱效应[95%CI:-2.760(-4.892~3.366)、-3.604(-5.813~4.353)]。两组患者不良反应发生率无统计学差异(P>0.05)。结论:白蛋白紫杉醇联合曲妥珠单抗及帕妥珠单抗治疗HER2阳性ABC患者具有明显疗效,可调节肿瘤标志物分泌,延长患者生存期,且具有一定安全性。

Objective:To explore the effect of albumin paclitaxel combined with trastuzumab and pertuzumab in the therapy of patients with human epidermal growth factor receptor 2(HER2)-positive advanced breast cancer(ABC).Methods:60 patients with HER2-positive ABC were selected and divided into control group and observation group according to the different treatment methods.The control group was given the docetaxel combined with trastuzumab and pertuzumab for therapy,and the observation group was given the albumin paclitaxel combined with trastuzumab and pertuzumab for therapy.Both groups were treated for 6 cycles(21 days per cycle).The clinical curative effect,survival time,tumor markers levels and the occurrence of adverse reactions were compared of both groups.Results:The objective response rate(ORR)and clinical benefit rate(CBR)of observation group were higher than those in the control group(P<0.05).The carbohydrate antigen(CA)15-3,carcinoembryonic antigen(CEA)and CA125 levels after therapy of both groups were decreased in comparison with before therapy(P<0.05),and the observation group were lower than the control group(P<0.05).The differences of CA15-3 and CEA levels after treatment between the both groups were highly effective[95%CI:1.142(4.347~11.533),1.485(1.900~3.941),P<0.05],and CA125 level was medium effective[95%CI:0.670(0.652~5.048)].The progression free survival(PFS)and overall survival(OS)of observation group were higher than those of the control group(P<0.05),the difference in PFS and OS between the both gooups were weakly effective[95%CI:-2.760(-4.892~3.366),-3.604(-5.813~4.353)].There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Albumin paclitaxel combined with trastuzumab and pertuzumab in the therapy of HER2-positive ABC patients has obvious curative effect,which can adjust the secretion of tumor markers,prolong the survival of patients,and with certain safety.