HER阳性转移性乳腺癌治疗策略方案.pptVIP

* * Reference Dawood SS et al. J Clin Oncol 2010 28: 92-98. Reprinted with permission. ?2008 American Society of Clinical Oncology. All rights reserved. * * 99 * * * 【H审核】 单用多西紫杉醇组患者部分交叉使用了赫赛汀?（至少48%），这些患者比没有交叉使用赫赛汀?的患者生存期更长。这些资料提示使用赫赛汀?比单用化疗更能改善患者生存期，提前使用赫赛汀?较化疗后续贯使用赫赛汀?获益更多 * Slide 9 The Andersson study is a prospective phase III, multicenter, randomized trial that was designed to evaluate the 有效性 and safety of NVB i.v. plus 曲妥珠单抗 as first-line regimen in patients with HER2 阳性. Patients were randomized to receive either NVB D1, D8 + 曲妥珠单抗 or 多西他赛 D1 plus 曲妥珠单抗 every three weeks. Patients population was well balanced between both arms. Median number of cycles received by patients was higher for those treated with NVB plus 曲妥珠单抗 (10.5 versus 8). Concerning the 有效性 results, OS, OR and TTP were better with 曲妥珠单抗 in combination with NVB. Furthermore, difference for TTF was clinically significant for NVB arm. Based on this efficay results, the author concluded that NVB combined with 曲妥珠单抗 should be considered a potentially better first line alternative. * Slide 10 Significantly more grade 3-4 白细胞下降, 发热性粒缺, 感染, 发热, neuropathy, 指甲异常 and 水潴留 were reported with 多西他赛. 20% of patients treated with 多西他赛 were discontinued due to 毒性 versus 6.5% of patients treated with NVB. * * * * 结论与启示：赫赛汀?治疗进展后持续使用长期获益 一线治疗7年 OS率为 17% （n= 220) 当赫赛汀? 持续治疗到疾病进展，OS率显著提高 (12.3% vs. 5.4%; P0.0001) 当赫赛汀? 持续治疗到疾病进展，中位OS显著提高 (3.1 vs. 1.45 year 法国观察研究长期随访资料为赫赛汀?治疗进展后使用取得长期获益增添了证据 617 General Poster Session (Board #11C), Mon, 1:00 PM-5:00 PM Long-term survival in patients with HER2-positive metastatic breast cancer treated with trastuzumab as first-line therapy: Seven-year follow-up of the French Observational Hermine Study. E. Antoine, F. Dalenc, C. Hebert, P. Rivera, G. Romieu, N. Varoqueaux, J. P. Guastalla, M. Namer; Clinique Hartmann, Neuilly-sur-Seine, France; Institut Claudius Regaud, Toulouse, France; Centre Antoine-Lacassagne, Nice, France; CHU Toulouse Rangueil, Toulouse, France; CR