依维莫司治疗激素受体阳性进展期乳腺癌疗效和安全性的回顾性研究

目的：回顾性分析依维莫司联合内分泌治疗对内分泌治疗耐药型激素受体阳性转移性乳腺癌患者的疗效和安全性。方法自2013年7月至2015年1月，入组18例依维莫司治疗的多线治疗患者的资料；依维莫司用量为10 mg/d ，随患者口腔溃疡程度调整剂量为5 mg/d或隔日5 mg ，联合依西美坦25 mg/d治疗者12例，联合来曲唑2.5 mg/d者3例，联合氟维司群每个月500 mg者3例（第一个月为500 mg分2次）；每两个月评估一次疗效，随时记录不良反应。结果18例患者的治疗时间为1～14个月；3例患者治疗1个月，其中1例因骨髓抑制停药，2例因费用停药。15例患者可评估疗效，4例（26.7%）获得部分缓解（partial response，PR），4例（26.7%）疾病稳定（stable disease，SD），7例（46.7%）疾病进展（progressive disease，PD）；中位无进展生存期（me-dian progression-free survival，mPFS)为6.5个月（2～14个月）。呼吸困难4例（2例出现肺间质病变，其中1例为严重病变）；几乎所有患者均存在不同程度的口腔溃疡，其中2例为4级的严重口腔溃疡伴发热；仅1例患者未减量，其余均因口腔溃疡导致依维莫司减量。结论经多线化疗和内分泌治疗后，依维莫司联合内分泌治疗对激素受体阳性转移性乳腺癌仍有一定的疗效，但需谨慎观察患者的不良反应。

A retrospective study of efficacy and safety for everolimus in hormone-receptor-positive advanced breast cancer

Objective To retrospectively analyze the efficacy and safety of everolimus (EVE) combined with en-docrine therapy in refractory hormone receptor positive advanced breast cancer (ABC). Method Eighteen patients treated in our hospital with EVE from July 2013 to January 2015 were analyzed. EVE was administered as 10 mg/d, and was decreased to 5 mg/d or 5 mg/another day based on stomatitis condition, 12 cases received endocrine therapy in combination with exemestane (EXE) 25 mg/d, and 3 cases were in combination with letrozole 2.5 mg/d, 3 cases were in combination with fulvestrant 500 mg/month (twice in first month); patients were evaluated each 2 month, and adverse effects were recorded at any time when patients complained. Result The duration of treatment for all pa-tients was 1-14 months, 3 cases discontinued from the therapy in 1 month for the reasons of bone marrow suppres-sion (1 case), and unaffordable costs (2 cases), leaving only 15 evaluable patients, in which there were no CR, while 4 patients obtained PR (26.7%, 4/15), 4 achieved SD (46.7%, 4/15), and 7 had PD (46.7%, 7/15); the median progres-sion free survival (mPFS) was 6.5 months (2-14 months); The major side effects: dyspnea in 4 patients (2 had serious pneumonitis, 1 death case), all patients had stomatitis in varied degrees, and 2 cases had severe stomatitis with fever, all patients except one experienced dose reduction due to stomatitis. Conclusion The everolimus plus endoncrine therapy is somewhat effective for patients with hormone receptor positive advanced breast cancer, who had several chemotherapies or endocrine therapy, while the adverse events should be monitored.