文章摘要

曲妥珠单抗联合帕妥珠单抗在HER2过表达乳腺癌中的应用价值

作者: 1马善义, 2马俊, 1吴芳芳, 1李春燕, 1杨帆, 1孙兆楼, 1程志原, 3江卫兵
1 宣城市中心医院肿瘤内科,安徽 宣城 242000
2 宣城市中心医院甲乳科,安徽 宣城 242000
3 宣城市中心医院胸外科,安徽 宣城 242000
通讯: 江卫兵 Email: 13805638053@163.com
DOI: 10.3978/j.issn.2095-6959.2021.07.017

摘要

目的:探究曲妥珠单抗联合帕妥珠单抗在HER2过表达乳腺癌(breast cancer,BC)中的应用价值。方法:纳入2019年1月至2020年12月宣城市中心医院收治的46例HER2过表达的BC患者,随机分为曲妥珠单抗组与联合组,每组各23例。在常规治疗的基础上,曲妥珠单抗组给予曲妥珠单抗静脉滴注治疗(首剂8 mg/kg,第2次及以后6 mg/kg);联合组在曲妥珠单抗基础上,再给予帕妥珠单抗治疗(帕妥珠单抗首剂840 mg,第2次及以后420 mg)。治疗过程中,记录患者所发生的不良反应(adverse reaction,ADR)并对ADR进行评级。疗程结束后,评价两组患者的疗效。随访收集患者的复发、转移和生存情况。结果:经治疗后,联合组的ORR为78.26%,曲妥珠单抗组的ORR为60.87%,显著低于联合组(P<0.05);联合组的HER2过表达率为47.83%,曲妥珠单抗组的过表达率为78.26%,显著高于联合组(P<0.05);采集病理标本复查,联合组有21例BC患者被评价为病理疗效有效,占91.30%。曲妥珠单抗组有15例BC患者被评价为病理疗效有效,占65.22%,人数百分比显著低于联合组(P<0.05)。治疗期间,联合组心悸的发生率为4.35%,显著低于曲妥珠单抗组心悸的发生率(26.09%,P<0.05)。治疗期间,联合组共发生36例ADR,曲妥珠单抗组共发生38例ADR,两组不同分级的ADR发生率相比,差异无统计学意义(P>0.05)。随访期内,联合组的转移率为4.35%,显著低于曲妥珠单抗组(P<0.05)。结论:曲妥珠单抗联合帕妥珠单抗治疗HER2过表达的BC患者疗效显著,安全性较高,值得推广应用。
关键词: 曲妥珠单抗;帕妥珠单抗;HER2过表达;乳腺癌

Application value of trastuzumab combined with pertuzumab in the treatment of HER2-overexpressed breast cancer

Authors: 1MA Shanyi, 2MA Jun, 1WU Fangfang, 1LI Chunyan, 1YANG Fan, 1SUN Zhaolou, 1CHENG Zhiyuan, 3JIANG Weibing
1 Department of Medical Oncology, Xuancheng City Center Hospital, Xuancheng Anhui 242000, China
2 Department of Thyroid Breast Surgery, Xuancheng City Center Hospital, Xuancheng Anhui 242000, China
3 Department of Cerebral Surgery, Xuancheng City Center Hospital, Xuancheng Anhui 242000, China

CorrespondingAuthor: JIANG Weibing Email: 13805638053@163.com

DOI: 10.3978/j.issn.2095-6959.2021.07.017

Abstract

Objective: To explore the application value of trastuzumab combined with pertuzumab in HER2 overexpression of breast cancer (BC). Methods: A total of 46 BC patients with HER2 overexpression admitted to our hospital from January 2019 to December 2020 were included and randomly divided into trastuzumab group and combination group, with 23 cases each. In addition to conventional treatment, the trastuzumab group was given intravenous drip treatment with trastuzumab (8 mg/kg for the first dose and 6 mg/kg for the second dose). In addition to trastuzumab, the combined group was treated with pertuzumab (840 mg for the first dose, 420 mg for the second and subsequent doses). During the treatment, adverse reactions (ADR) of the patients were recorded and graded. At the end of the course, the efficacy of the two groups was evaluated. Patients were followed up for recurrence, metastasis, and survival. Results: After treatment, ORR of the combined group was 78.26% and that of the trastuzumab group was 60.87%, significantly lower than that of the combined group (P<0.05). The overexpression rate of HER2 in the combined group was 47.83% and that in the trastuzumab group was 78.26%, significantly higher than that in the combined group (P<0.05). Pathological specimens were collected for reexamination, and 21 BC patients in the combined group were assessed as having effective pathological efficacy, accounting for 91.30%. In the trastuzumab group, 15 BC patients were evaluated as having effective pathological efficacy, accounting for 65.22%, and the percentage was significantly lower than that of the combined group (P<0.05). During treatment, the incidence of palpitations in the combined group was 4.35%, significantly lower than that in the trastuzumab group (26.09%) (P<0.05). During treatment, there were a total of 36 cases of ADR in the combined group and 38 cases of ADR in the trastuzumab group, and there was no significant difference in the incidence of ADR of different grades between the two groups (P>0.05). During the follow-up period, the metastasis rate in the combined group was 4.35%, significantly lower than that in the trastuzumab group (P<0.05). Conclusion: Trastuzumab combined with pertuzumab is effective and safe in the treatment of BC patients with HER2 overexpression, which is worthy of popularization and application.
Keywords: trastuzumab; pertuzumab; HER2 overexpression; breast cancer