曲妥珠单抗联合长春瑞滨对Her-2/neu高表达的转移性乳腺癌的治疗作用

目的 观察曲妥珠单抗联合长春瑞滨治疗Her-2/neu高表达的转移性乳腺癌的疗效与毒副作用.方法 21例Her-2/neu高表达转移性乳腺癌患者,接受曲妥珠单抗联合长春瑞滨方案治疗,曲妥珠单抗2mg/kg静脉滴注d1,d8,d15或者6 mg/kg静脉滴注d1,(首次加2 mg/kg),长春瑞滨25 mg/m2静脉推注d1、d8,每21 d重复一次.结果 全组21例共完成56个周期(中位数2周期,范围1～6周期),均可评价疗效.完全缓解1例,部分缓解6例,病情稳定4例.病情进展10例,客观有效率(完全缓解加部分缓解)33.33%,中位疾病进展时间3.5个月,1年生存率33%.主要不良反应是骨髓抑制及周围神经炎,部分患者有发热和轻度的心肌劳损.结论 曲妥珠单抗联合长春瑞滨方案治疗Her-2/neu高表达的重度复治的转移性乳腺癌患者,仍有一定疗效,且毒副作用轻.

Efficacy and toxicity of trastuzumab combined vinorelbine in 21 patients with HER2 overexpressing metastatic breast cancer

OBJECTIVE: To evaluate the efficacy and toxicity in patients with HER2 overexpressing metastatic breast cancer. METHODS: Twenty-one patients with HER2 overexpressing metastatic breast cancer entered into the study. Trastuzumab (8 mg/kg day 1, then 6 mg/kg every 21 days or 4 mg/kg, then 2 mg/kg every week) and vinorelbine (25 mg/m(2)) was given on days 1 and 8 every 21 days. RESULTS: Overall 56 cycles were given to the 21 patients enrolled into the study (mean 2, range 1-6). All can be evaluated. The response rate was 33.33% (7/21), one patient achieved complete response (CR), six patients achieved partial response (PR), four patients achieved stable disease (SD), ten patients achieved progressive disease (PD)]. The median time to progression was 3.5 months. One year overall survival was 33%. The major toxicity was myelosuppression and peripheral neuritis. A few patients were observed with fever and lower grade cardiac failure. CONCLUSION: The combination of trastuzumab and vinorelbine is an effective and well tolerated therapy in patients with pretreated metastatic breast cancer.