β受体拮抗剂是否可以延长晚期HER2阴性乳腺癌患者生存时间?

2017-09-19 佚名 环球医学编译

2017年8月在《Ann Oncol.》上发表的一项研究,调查了β-受体拮抗剂(BB)与晚期HER2阴性乳腺癌患者无进展生存(PFS)改善之间的相关性,最终的研究结果表明摄入BB与PFS的显著改善相关,尤其是对于三阴性乳腺癌患者和既往未接触过BB的患者。



2017年8月在《Ann Oncol.》上发表的一项研究,调查了β-受体拮抗剂(BB)与晚期HER2阴性乳腺癌患者无进展生存(PFS)改善之间的相关性,最终的研究结果表明摄入BB与PFS的显著改善相关,尤其是对于三阴性乳腺癌患者和既往未接触过BB的患者。

背景:近期的回顾性研究显示BB与多种癌症的结局改善相关。虽然有限和不一致的数据显示,BB可能会增加局部乳腺癌的总生存期(OS),但是没有关于BB对晚期乳腺癌患者的影响的证据。

受试者和方法:为了考察BB使用与乳腺癌患者结局之间的相关性,研究者回顾性评价了ROSE/TRIO-012,这是一项双盲、多国III期试验,随机化1144例HER2阴性晚期乳腺癌患者至一线多西他赛联合雷莫芦单抗组或联合安慰剂组。研究者比较了使用BB与没有使用BB的患者的PFS、OS、总响应率ORR,以及临床获益率CBR。

结果:1144例(13%)患者中有153例患者使用BB;62%的患者在入组前使用BB,38%的患者在入组后使用BB。使用BB治疗的患者的中位PFS长于没有使用BB的患者(10.3月vs 8.3?月;HR 0.81;95% CI 0.66~0.99;P?=?0.038)。入组后接受BB患者中位PFS更长(15.5月vs 8.3月,P<0.001)。在三阴性乳腺癌亚组中,BB使用者的中位PFS为13.0个月,没有使用BB的患者的中位PFS为5.2个月(HR 0.52;95% CI 0.34~0.79;P?=?0.002)。使用BB在PFS的获益是独立于其治疗诱发的高血压(P = 0.476),但与治疗组别存在相关性(P = 0.037)。测试的BB和治疗组别之间相互作用并不显著(P = 0.276)。在OS、ORR,CBR方面没有差异。验证数据集分析显示结果一致,在BCIRG-005试验中使用BB的淋巴结阳性可手术乳腺癌女性的结局没有显著改善。

结论:在这此探索性分析中,使用BB与PFS的显著改善相关,尤其是对于三阴性乳腺癌患者和既往未接触过BB的患者。

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