吡咯替尼联合THP方案治疗晚期HER-2阳性乳腺癌疗效和预后分析

Efficacy and prognostic analysis of pyrotinib combined with THP regimen in the treatment of advanced HER-2 positive breast cancer

目的探究吡咯替尼联合THP方案治疗晚期HER-2阳性患者的疗效和预后。方法收集2019年6月~2020年11月就诊于沧州市中心医院的晚期HER-2阳性乳腺癌患者121例,按照不同的治疗方案分为对照组(n=61)和观察组(n=60)。两组均给予THP方案治疗,观察组在此基础上给予吡咯替尼治疗,21d为1个治疗周期,均治疗4个周期。观察两组客观缓解率(ORR)和疾病控制率(DCR),无进展生存期(PFS)和总生存期(OS),并比较治疗前后其肿瘤标志物水平(VEGF、CEA、CA153、CA125)、T淋巴细胞亚群水平以及不良反应的发生情况。结果治疗后观察组ORR较对照组高(85.00%vs.68.85%,P<0.05),PFS延长(15.80个月vs.9.70个月,t=-5.142,P<0.01),两组DCR无明显差别(P>0.05);观察组肿瘤标志物VEGF、CEA、CA153、CA125水平较对照组下降更为明显(P<0.05);两组CD4^(+)T细胞明显下降,CD8^(+)T细胞明显升高,与治疗前比较差异均有统计学意义(P<0.001),且对照组的变化更为明显;两组不良反应的发生情况无统计学差异(P>0.05)。结论吡咯替尼联合THP方案治疗晚期HER-2阳性乳腺癌患者具有较好的临床疗效和预后,可以改善肿瘤细胞的生物学行为,不增加不良反应,安全性较好。

Objective To investigate the efficacy and prognosis of pyrotinib combined with THP regimen in the treatment of advanced HER-2 positive breast cancer patients.Methods A total of 121 patients with advanced HER-2 positive breast cancer who were admitted to Cangzhou Central Hospital from June 2019 to November 2020 were collected and divided into a control group(n=61)and an observation group(n=60)based on different treatment regimens.Both groups were treated with the THP regimen,while the observation group received pyrotinib treatment on this basis.The treatment cycle was 21 days,and both groups were treated for 4 cycles.The objective response rate(ORR)and disease control rate(DCR),progression-free survival(PFS),and overall survival(OS)were observed in both groups.The levels of tumor markers(VEGF,CEA,CA153,CA125),T lymphocyte subsets,and the occurrence of adverse reactions were compared before and after treatment.Results After treatment,the ORR in the observation group was higher than that in the control group(85.00%vs.68.85%,P<0.05),and the PFS was prolonged(15.80 months vs.9.70 months,t=-5.142,P<0.01).There was no significant difference in DCR between the two groups(P>0.05).The levels of tumor markers VEGF,CEA,CA153,and CA125 in the observation group decreased more significantly than those in the control group(P<0.05).The CD4^(+)T cell decreased significantly,and the CD8^(+)T cell increased significantly in both groups,with statistically significant differences compared with before treatment(P<0.001),and the changes in the control group were more pronounced.There was no statistical difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion Pyrotinib combined with THP regimen has good clinical efficacy and prognosis in the treatment of patients with advanced HER-2 positive breast cancer,which can improve the biological behavior of tumor cells without increasing adverse reactions,indicating good safety.