阿帕替尼联合依托泊苷治疗三阴性乳腺癌的疗效及不良反应

目的探讨甲磺酸阿帕替尼联合依托泊苷治疗晚期、复发、难治性三阴性乳腺癌的疗效及不良反应。方法收集10例晚期复发难治性三阴性乳腺癌患者的临床资料,均接受甲磺酸阿帕替尼联合依托泊苷治疗,观察用药后疾病控制率(DCR)、客观缓解率(ORR)、无进展生存期(PFS)并记录不良反应。结果10例患者均接受了至少2个周期的治疗,无完全缓解病例,部分缓解4例,疾病稳定5例,疾病进展1例,ORR为40%(4/10),DCR为90%(9/10),中位PFS为4.0个月(95%CI:1.15~6.85)。阿帕替尼联合依托泊苷作为二线治疗方案治疗晚期复发难治性三阴性乳腺癌患者的中位PFS为4.0个月,与作为二线以上治疗方案的3.0个月比较,差异无统计学意义(P﹥0.05)。阿帕替尼联合依托泊苷治疗2个部位转移三阴性乳腺癌患者的中位PFS为4.0个月,与治疗2个以上部位转移患者的7.0个月比较,差异无统计学意义(P﹥0.05)。10例三阴性乳腺癌患者最常见治疗相关不良反应为中性粒细胞减少,发生率为50.0%,不良反应以1~2级为主,仅发生1例3~4级不良反应,经对症治疗后好转,无治疗相关死亡。结论甲磺酸阿帕替尼联合口服依托泊苷化疗对晚期复发难治性三阴性乳腺癌有一定疗效,不良反应可控。

Efficacy and adverse reactions of apatinib combined with etoposide in the treatment of triple-negative breast cancer

Objective To explore the efficacy and adverse reactions of apatinib mesylate combined with etoposide on advanced,relapsed,and refractory triple-negative breast cancer.Method The clinical data of 10 patients with advanced relapsed and refractory triple-negative breast cancer were collected,all received apatinib mesylate combined with etoposide treatment,The disease control rate(DCR),objective response rate(ORR),progression-free survival(PFS)after medication and record adverse reactions.Result All 10 patients received at least 2 cycles of treatment,there was no complete remission,4 partial remission,5 stable disease,1 disease progression,ORR was 40%(4/10),and DCR was 90%(9/10),the median PFS was 4.0 months(95%CI:1.15-6.85).There was no significant difference for the median PFS between the apatinib combined etoposide as the second line treatment of advanced,recurrent and refractory triple negative breast cancer versus the≥2 lines of treatment(4.0 months vs 3.0 months,P>0.05).The median PFS of apatinib combined with etoposide in the treatment of triple-negative breast cancer patients with metastases at 2 sites was 4.0 months,compared with 7.0 months in patients with metastases at≥2 sites,the difference was not statistically significant(P>0.05).The most common adverse reactions were neutropenia,with an incidence rate of 50.0%,most with grade 1-2 events,only 1 case with grade 3-4 events,all of which recovered after symptomatic treatment,no treatment related death.Conclusion Apatinib mesylate combined etoposide can achieve moderate effect in the treatment of advanced,recurrent and refractory triple negative breast cancer with controllable adverse reactions.