Effect of combination of bevacizumab and TH regimen chemotherapy on T cell subsets in peripheral blood and clinical prognosis of Her-2 positively metastatic breast cancer
LV You1,WANG Xiaoyue1,SHI Chaofan1,and JIANG Wei2
1.Brigade 2, Logistics College of Chinese People’s Armed Police Force, Tianjin 300162, China; 2.Scientific Research and Training Section, General Hospital of Chinese People’s Armed Police Force, Beijing 100039,China
Abstract：Objective To investigate the effect of bevacizumab combined with TH chemotherapy on T cell subsets in peripheral blood and clinical prognosis in human epidermal growth factor receptor 2 (Her-2) positive patients with metastatic breast cancer.Methods Between Jan, 2012 and Jan, 2014, 100 patients with Her-2 positive metastatic breast cancer were prospectively recruited in this study. These patients were randomly assigned into a study group or a control group. The study group was treated with bevacizumab combined with TH chemotherapy while the control group was treated with TH chemotherapy alone. The patients were followed up for two years.The primary outcomes included CD4+T cells, CD8+T cells, solid tumor efficacy evaluation grades, progression free survival and 2-year mortality.Results There was no significant difference in CD8+T cells between the two groups before and after treatment. After treatment, the expression of CD4+T cells in the study group (P=0.422) was significantly higher than that in the control group (P=0.011). The rates of complete remission, partial remission, stable disease and progressive disease in the study groups were 0.00%, 36.00%, 42.00% and 22.00%, compared to 0.00%, 18.00%, 44.00% and 38.00% in the control group (P=0.025). Two years later, 9 patients in the study group died, and the mortality rate was 18.00%, while 20 patients in the control group died, and the mortality rate was 40.00%. The difference was statistically significant (P=0.015). Wilcoxon test showed that the duration of progression free survival in the study group was significantly longer than that in the control group (P=0.007).Conclusions The combination of bevacizumab and TH chemotherapy in patients with Her-2-positive metastatic breast cancer may help to improve the immune function and clinical prognosis.
吕 游,王笑月,史超凡,姜 威. 两种化疗方案对转移性乳腺癌外周血T细胞亚群 和临床预后影响的比较[J]. 武警医学, 2017, 28(6): 605-608.
LV You,WANG Xiaoyue,SHI Chaofan,and JIANG Wei. Effect of combination of bevacizumab and TH regimen chemotherapy on T cell subsets in peripheral blood and clinical prognosis of Her-2 positively metastatic breast cancer. Med. J. Chin. Peop. Armed Poli. Forc., 2017, 28(6): 605-608.
Taira N, Arai M, Ikeda M, et al. The Japanese Breast Cancer Society clinical practice guidelines for epidemiology and prevention of breast cancer, 2015 edition[J]. Breast Cancer,2016,23(3):343-356.
[2]
O SH, L AH, N AA, et al. Epidemiology of Breast Cancer among Females in Basrah[J]. Asian Pac J Cancer Prev,2016,17(2):191-195.
[3]
Li T, Mello-Thoms C, Brennan P C. Descriptive epidemiology of breast cancer in China: incidence, mortality, survival and prevalence[J]. Breast Cancer Res Treat,2016,159(3):395-406.
[4]
Ghoncheh M, Pournamdar Z, Salehiniya H. Incidence and Mortality and Epidemiology of Breast Cancer in the World[J]. Asian Pac J Cancer Prev,2016,17(5):43-46.
Keyhani E, Muhammadnejad A, Karimlou M. Prevalence of HER-2-positive invasive breast cancer: a systematic review from Iran[J]. Asian Pac J Cancer Prev,2012,13(11):5477-5482.
[7]
Yu A F, Manrique C, Pun S, et al. Cardiac safety of paclitaxel plus trastuzumab and pertuzumab in patients with HER2-positive metastatic breast cancer[J]. Oncologist,2016,21(4):418-424.
[8]
Uriarte-Pinto M, Escolano-Pueyo A, Gimeno-Ballester V, et al. Trastuzumab, non-pegylated liposomal-encapsulated doxorubicin and paclitaxel in the neoadjuvant setting of HER-2 positive breast cancer[J]. Int J Clin Pharm,2016,38(2):446-453.
[9]
Berghoff A S, Bago-Horvath Z, Dubsky P, et al. Impact of HER-2-targeted therapy on overall survival in patients with HER-2 positive metastatic breast cancer[J]. Breast J,2013,19(2):149-155.
Kader Y A, Spielmann M, El-Nahas T, et al. Comparative study analyzing survival and safety of bevacizumab/carboplatin/paclitaxel versus carboplatin/docetaxel in initial treatment of metastatic Her-2-negative breast cancer[J]. Breast Cancer (Dove Med Press),2013,5(2):37-42.
[12]
Stark D, Nankivell M, Pujade-Lauraine E, et al. Standard chemotherapy with or without bevacizumab in advanced ovarian cancer: quality-of-life outcomes from the International Collaboration on Ovarian Neoplasms (ICON7) phase 3 randomised trial[J]. Lancet Oncol,2013,14(3):236-243.
[13]
Krohn M, Listing M, Tjahjono G, et al.Depression, mood, stress, and Th1/Th2 immune balance in primary breast cancer patients undergoing classical massage therapy[J].Support Care Cancer,2011,19(9):1303-1311.
[14]
Kiyomi A, Makita M, Ozeki T, et al. Characterization and Clinical Implication of Th1/Th2/Th17 cytokines produced from three-dimensionally cultured tumor tissues resected from breast cancer patients[J]. Transl Oncol,2015,8(4):318-326.
[15]
Nunez C, Lozada-Requena I, Ysmodes T, et al. Immunomodulation of Uncaria tomentosa over dendritic cells, il-12 and profile TH1/TH2/TH17 in breast cancer[J]. Rev Peru Med Exp Salud Publica,2015,32(4):643-651.
[16]
Tredan O, Manuel M, Clapisson G, et al. Patients with metastatic breast cancer leading to CD4+ T cell lymphopaenia have poor outcome[J]. Eur J Cancer,2013,49(7):1673-1682.
2017, Vol. 28 
