顺铂对比卡铂联合紫杉醇用于三阴性乳腺癌新辅助治疗
OncoTargets and Therapy
既往研究已经证实铂类用于三阴性乳腺癌新辅助治疗的有效性和安全性。不过，顺铂与卡铂相比，对于三阴性乳腺癌新辅助治疗，究竟孰优孰劣尚不明确。
2017年12月，英国德孚旗下《肿瘤标靶与疗法》正式发表复旦大学附属肿瘤医院黄亮、刘琪、陈盛、邵志敏的研究报告，对顺铂或卡铂联合紫杉醇用于三阴性乳腺癌新辅助治疗的有效性和安全性进行了比较。
该研究回顾分析了145例三阴性乳腺癌患者，比较了顺铂和卡铂的活性和耐受性。两组患者接受每周紫杉醇＋铂类化疗。
结果发现，经过四个周期化疗后，顺铂组和卡铂组相比：
临床客观缓解率：87%比82%（P=0.570）
病理完全缓解率：44%比42%（P=0.789）
两种铂类化疗方案的生存曲线分析结果相似：
无病生存（对数秩P=0.877）
总体生存（对数秩P=0.663）
最常见的3/4级不良事件均为中性粒细胞减少和白细胞减少，不良事件组间无显著差异。
因此，对于三阴性乳腺癌患者，两种铂类＋每周紫杉醇均为可行的治疗方法，临床客观缓解率、病理完全缓解率、耐受性相似。
此前，仅有研究比较了顺铂与卡铂用于晚期三阴性乳腺癌治疗，本文填补了比较顺铂与卡铂用于早期三阴性乳腺癌的研究空白。
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Onco Targets Ther. 2017 Dec 1;10:5739-5744.
Cisplatin versus carboplatin in combination with paclitaxel as neoadjuvant regimen for triple negative breast cancer.
Huang L, Liu Q, Chen S, Shao Z.
Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, China; Shanghai Medical College, Fudan University, Shanghai, China.
BACKGROUND: Platinum salts have demonstrated sufficient efficacy and safety for consideration of their use in a neoadjuvant setting for triple negative breast cancer (TNBC).
PATIENTS AND METHODS: We retrospectively analyzed 145 TNBC cases to compare the activity and tolerability of cisplatin and carboplatin. Two groups received weekly paclitaxel and platinum salts.
RESULTS: In total, 87% of patients in the cisplatin group and 82% of patients in the carboplatin group experienced a clinical objective response after four cycles (complete response or partial response; P=0.570). Pathological complete response (pCR) occurred similarly in the cisplatin group and the carboplatin group (44% versus 42%, P=0.789). In survival analysis, there was no difference between the two regimens. The most common grade 3/4 adverse events were neutropenia and leukopenia.
CONCLUSION: There was no significant difference between the groups in terms of adverse events. Both types of platinum salts and weekly paclitaxel are feasible therapies that achieved high pCR rates and tolerability in TNBC patients.
KEYWORDS: carboplatin; cisplatin; neoadjuvant chemotherapy; pathological complete response; triple negative breast cancer
PMID: 29238206
PMCID: PMC5716301
DOI: 10.2147/OTT.S145934