Evaluation of the efficacy of albumin-bound paclitaxel combined with carboplatin in treatment of advanced triple-negative breast cancer
HE Bo1, HOU Xaojie2, MU Yuan3
1. Department of Oncology, the Third Medical Center of Chinese PLA General Hospital, Beijing100039, China; 2. Department of Medical Research, 3. Medical Quality and Safety Management Section, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin 300162, China
摘要目的 探讨白蛋白结合型紫杉醇联合卡铂治疗晚期三阴性乳腺癌(TNBC)的近期和远期疗效。方法 选取2018-03-01至2020-12-31解放军总医院第三医学中心肿瘤科收治的120例晚期转移性TNBC为研究对象,按随机数字表法平均分为两组,对照组采用白蛋白结合型紫杉醇联合吉西他滨方案治疗,观察组采用白蛋白结合型紫杉醇联合卡铂方案治疗,对比观察两组患者的近期治疗效果、血清肿瘤指标变化、远期治疗效果及不良反应发生情况。结果 在随访近期,两组患者的客观缓解率(objective response rate, ORR)及疾病控制率(disease control rate, DCR)对比差异无统计学意义,观察组患者的血清CA125、CA15-3、中期因子(MK)及血小板第4因子(PF4)水平均显著低于对照组(P<0.05),观察组中位无进展生存时间(mPFS)明显长于对照组(4.20个月 vs. 3.44个月,P<0.05),两组患者的中位总生存时间(mOS)对比差异无统计学意义;在随访远期,观察组的mPFS明显优于对照组(6.77个月 vs. 5.75个月,P<0.05),观察组患者的mOS明显优于对照组(10.77个月 vs. 8.78个月,P<0.05)。两组患者的治疗不良反应发生率对比无统计学差异。结论 白蛋白结合型紫杉醇联合卡铂的近期、远期治疗效果均优于白蛋白结合型紫杉醇联合吉西他滨,而两种方案的不良反应未见明显差异。
Abstract:Objective To observe the short and long term efficacy of albumin-bound paclitaxel combined with carboplatin in the treatment of advanced triple-negative breast cancer(TNBC).Methods A total of 120 patients with advanced metastatic TNBC admitted to the Oncology Department of the Third Medical Center of Chinese PLA General Hospital from March 1, 2018 to December 31, 2020 were selected as the research objects. They were divided into two groups according to the method of random number. The control group was treated with albumin-bound paclitaxel combined with gemcitabine regimen, while the observation group was treated with albumin-bound paclitaxel combined with carboplatin regimen. The short-term treatment effect, changes of serum tumor indexes, long-term treatment effect and incidence of adverse reactions were compared between the two groups.Results During the short-term follow-up, there was no significant difference in Objective response rate (ORR)and disease control rate (DCR) between the two groups (P<0.05). Serum CA125, CA15-3, MK and PF4 in the observation group were significantly lower than those in the control group, and the median progression-free survival time (mPFS) in the observation group was significantly longer than that in the control group (4.20 months vs. 3.44 months, P<0.05), there was no significant difference in mOS between the two groups. In the long-term follow-up, mPFS of the observation group was significantly better than that of the control group (6.77 months vs. 5.75 months, P<0.05), and mOS of the observation group was significantly better than that of the control group (10.77 months vs. 8.78 months, P<0.05). There was no significant difference in adverse reactions between the two groups.Conclusions The short-term and long-term efficacy of albumin-bound paclitaxel combined with carboplatin is due to the combination of albumin-bound paclitaxel and gemcitabine, and there is no significant difference in adverse reactions between the two kinds of treatment.
何波, 侯晓杰, 慕媛. 白蛋白结合型紫杉醇联合卡铂治疗晚期三阴性乳腺癌的疗效评估[J]. 武警医学, 2023, 34(2): 150-156.
HE Bo, HOU Xaojie, MU Yuan. Evaluation of the efficacy of albumin-bound paclitaxel combined with carboplatin in treatment of advanced triple-negative breast cancer. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(2): 150-156.
Yin L, Duan J J, Bian X W, et al. Triple-negative breast cancer molecular subtyping and treatment progress [J]. Breast Cancer Res, 2020, 22(1): 61.
[2]
Milioli H H, Tishchenko I, Riveros C, et al Basal-like breast cancer: molecular profiles, clinical features and survival outcomes[J]. BMC Med Genomics, 2017,10(1):19.
[3]
Bergin A R T, Loi S. Triple-negative breast cancer: recent treatment advances[J]. F1000Res, 2019,8:F1000 Faculty Rev-1342.
[4]
Kim R, An M, Lee H, et al. Early tumor-immune microenvironmental remodeling and response to first-line fluoropyrimidine and platinum chemotherapy in advanced gastric cancer [J]. Cancer Discov, 2022, 12(4): 984-1001.
[5]
Hu X C, Zhang J, Xu B H, et al. Cisplatin plus gemcitabine versus paclitaxel plus gemcitabine as first-line therapy for metastatic triple-negative breast cancer (CBCSG006): a randomised, open-label, multicentre, phase 3 trial [J]. Lancet Oncol, 2015, 16(4): 436-446.
[6]
Zhang J, Lin Y, Sun X J, et al. Biomarker assessment of the CBCSG006 trial: a randomized phase III trial of cisplatin plus gemcitabine compared with paclitaxel plus gemcitabine as first-line therapy for patients with metastatic triple-negative breast cancer [J]. Ann Oncol, 2018, 29(8): 1741-1747.
[7]
Kundranda M N, Niu J. Albumin-bound paclitaxel in solid tumors: clinical development and future directions[J]. Drug Des Devel Ther, 2015, 9: 3767-3777.
[8]
Forero-Torres A, Varley K E, Abramson V G, et al. TBCRC 019: a phase II trial of nanoparticle albumin-bound paclitaxel with or without the anti-death receptor 5 monoclonal antibody tigatuzumab in patients with triple-negative breast cancer [J]. Clin Cancer Res, 2015, 21(12): 2722-2729.
[9]
Blohmer J U, Link T, Reinsch M, et al. Effect of denosumab added to 2 different nab-paclitaxel regimens as neoadjuvant therapy in patients with primary breast cancer: the geparX 2×2 randomized clinical trial [J]. JAMA Oncol, 2022, 8(7): 1010-1018.
Cavaletti G, Frigeni B, Lanzani F, et al. Chemotherapy-induced peripheral neurotoxicity assessment: a critical revision of the currently available tools [J]. Eur J Cancer, 2010, 46(3): 479-494.
[12]
Garrida-Castro A C, Lin N U, Polyak K. Insights into molecular classifications of triple-negative breast cancer: improving patient selection for treatment [J]. Cancer Disc, 2019, 9(2): 176-198.
[13]
Parisi A, Palluzzi E, Cortellini A, et al. First-line carboplatin/nab-paclitaxel in advanced ovarian cancer patients, after hypersensitivity reaction to solvent-based taxanes: a single-institution experience [J]. Clin Transl Oncol, 2020, 22(1): 158-162.
Yardley D A, Coleman R, Conte P, et al. Nab-Paclitaxel plus carboplatin or gemcitabine versus gemcitabine plus carboplatin as first-line treatment of patients with triple-negative metastatic breast cancer: results from the tnAcity trial [J]. Ann Oncol, 2018, 29(8): 1763-1770.
Tutt A, Tobey H, Cheang M C U, et al. Carboplatin in BRCA1/2-mutated and triple-negative breast cancer BRCAness subgroups: the TNT Trial [J]. Nat Med, 2018, 24(5): 628-637.
Filippou P S, Karagiannis G S, Constantinidou A. Midkine (MDK) growth factor: a key player in cancer progression and a promising therapeutic target [J]. Oncogene, 2020, 39(10): 2040-2054.
[21]
Vandercappellen J, van Damme J, Struye S. The role of the CXC chemokines platelet factor-4 (CXCL4/PF-4) and its variant (CXCL4L1/PF-4var) in inflammation, angiogenesis and cancer [J]. Cytokine Growth Factor Rev, 2011, 22(1): 1-18.