口服依托泊苷治疗难治性转移性乳腺癌的疗效及安全性

严颖; 邸立军; 李惠平; 宋国红; 姜晗昉; 梁旭; 邵彬; 林晓琳; 宛凤玲

doi:10.3971/j.issn.1000-8578.2017.05.007

口服依托泊苷治疗难治性转移性乳腺癌的疗效及安全性

Efficacy and Safety of Oral Etoposide on Heavily Pretreated Metastatic Breast Cancer

摘要

摘要:
目的评价口服依托泊苷治疗转移性乳腺癌的疗效和不良反应。
方法回顾性分析88例接受口服依托泊苷治疗的转移性乳腺癌患者资料。口服依托泊苷50 mg/d, d1~20，每28天为一周期。
结果共纳入88例乳腺癌患者，83.0%（73/88）为三线以上治疗，78.4%（69/88）既往用蒽环类、紫杉类药物及卡培他滨治疗过。88例患者采用口服依托泊苷方案中位化疗5周期，均可评价疗效，其中部分缓解（PR）7例（8.0%），疾病稳定（SD）50例（56.8%），疾病进展（PD）31例（35.2%），无完全缓解（CR）患者。客观缓解率（CR+PR）为8.0%，临床获益率（CR+PR+SD≥6.0月）为44.3%。整体中位无进展生存期（PFS）为5.0月（95%CI: 3.8~6.2月），中位生存期（OS）为17.0月（95%CI: 11.3~22.7月）。主要不良反应为1~2级恶心18例（20.5%），1~2级中性粒细胞减少19例（21.6%），3级中性粒细胞减少3例（3.4%）。
结论口服依托泊苷治疗难治性转移性乳腺癌耐受性好、有一定疗效。

Abstract:
Objective To determine the efficacy and safety of oral etoposide on metastatic breast cancer.
Methods In this retrospective trial, 88 metastatic breast cancer (MBC) patients received oral etoposide 50 mg/d on days 1-20 every 28 days.
Results A total of 88 patients with MBC were enrolled, 83.0%(73/88) of the patients received multiple line (≥3 lines) chemotherapy, and 78.4%(69/88) of the patients had been pretreated with anthracycline, taxane, and capecitabine. All patients received median five cycles of oral etoposide therapy and all were evaluable for response, 7(8.0%) patients achieved partial response (PR), 50(56.8%) patients had stable disease (SD), 31(35.2%) had progressive disease (PD) and no one achieved complete response (CR). The objective response rate (ORR, CR+PR) was 8.0% and the clinical benefit rate (CBR, CR+PR+SD≥6.0 months) was 44.3%. Median progression free survival (PFS) was 5.0 months (95%CI: 3.8-6.2 months). Median overall survival (OS) was 17.0 months (95%CI: 11.3-22.7 months). The main toxicities were grade 1-2 nausea (20.5%), grade 1-2 neutropenia (21.6%), grade 3 neutropenia (3.4%).
Conclusion Oral etoposide could be an option with efficacy and safety for heavily pretreated metastatic breast cancer.

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