铂化合物对三阴性乳腺癌的疗效好

　　High efficacy of platinum compounds in TRIPLE NEGATIVE BREAST CANCER

　　P.A. Kern^1,2, H.-C. Kolberg³, A. Kalisch¹, M. Rezai², R. Kimmig¹, D. Pott⁴, F. Otterbach⁵, C. Kurbacher⁶

　　¹Women´s Department, University Clinic Essen, Essen, ²Breast Unit, Breast Center Düsseldorf Luisenkrankenhaus, Düsseldorf, ³Women´s Department, Marien Hospital Bottrop, ⁴Haemato-Oncology, Medical Center for Haemato-Oncology Bottrop, Bottrop, ⁵Pathology, Institute of Pathology, Soest, ⁶Gynaecological Oncology, Medical Center Bonn-Friedensplatz, Bonn, Germany

　　Introduction: Triple-Negative Breast Cancer (TNBC) is associated with a poor prognosis unless a pathological complete response (pCR) is achieved or almost achieved (near-pCR). There are no specific treatment guidelines for TNBC and considerably many patients fail to respond to standard anthracyclin-based chemotherapy regimens. TNBC and BRCA1-associated breast cancer are overlapping in their features to some extent and preclinical data suggest that platin analogues may act in both tumour entities.

　　Aim: This trial is designed to improve pCR-rates with the addition of Carboplatin to a taxane-based, anthracycline-free chemotherapy.

　　Methods: 31 patients with primary, unilateral, non-metastasized TNBC (majority of them cT1 or cT2, two cT3 , one cT4a and one cT4b) had to be unsuitable for or refusing the standard anthracycline-based chemotherapy. They received 6 cycles, respectively in 3 cases only 5 cycles, of Carboplatin AUC 6 and Docetaxel 75 mg/m² q3w. Primary endpoint was pathological complete response (pCR) and near-pCR, secondary endpoint toxicity.

　　Results: 21 of 31 patients (67%) had either a pathological complete response (48 %; 15/31) or a near-complete response (19%, 6/31) both being associated with a good prognosis. 9 remaining patients had a partial response, thus 97 % (30/31) responded. Treatment was well tolerated - Grade III and IV toxicities were predominantly concerning neutropenia.

　　Conclusions: The results show a high anti-tumour activity of docetaxel and carboplatin even omitting anthracyclines in neoadjuvant chemotherapy for TNBC with good feasibilty. Ongoing trials will show whether adding non-pegylated anthracyclines to weekly paclitaxel and carboplatin AUC2 will increase the pCR-rate (GEPAR-SIXTO/GermanBreastGroup).

　　更多精彩内容，请点击专题报道：http://zt.cmt.com.cn/zt/igcs2012/index.html