JCO：艾瑞布林可有效治疗转移性乳腺癌

  近日，发表于国际杂志Journal of Clinical Oncology上的一项研究报告中，来自达特茅斯-希契科克医疗中心（Dartmouth-Hitchcock Medical Center）的科学家通过研究表明，尽管艾瑞布林并不优于卡培他滨，但依然可以作为一种耐受性良好的疗法来有效抑制女性患者转移性的乳腺癌；本研究首次揭示艾瑞布林可以用于转移性乳腺癌的早期治疗中。

  研究者Kaufman表示，基于子集分析的结果显示，艾瑞布林或许可以积极有效地用于治疗三阴性转移性乳腺癌，三阴性转移性乳腺癌是一种恶性的乳腺癌，其预后往往较差。曾经在很多国家，艾瑞布林被认为是治疗转移性乳腺癌的三线甚至是更靠后的药物疗法，然而在治疗过程中该药物却是唯一一种可以有效提高患者生存率的化疗制剂。

  结合此前的研究结果和本文的研究，研究者表示，艾瑞布林或许应该用于转移性乳腺癌治疗的早期阶段；研究人员随后对1099名患者进行了III期临床随机试验研究，这些个体曾经都使用蒽环霉素或紫杉烷及卡培他滨或艾瑞布林进行一、二、三次恶性的转移性乳腺癌的治疗，而分层因素包括人表皮生长因子受体-2（HER2）和地理区域等。

  研究者表示，相比卡培他滨而言，艾瑞布林治疗对于改善患者的总体生存率在统计学上并无明显差异，而利用艾瑞布林治疗使得患者的平均存活期(median overall survival)在数字上稍优于卡培他滨的结果。

  当前研究人员希望通过更为深入的研究，来评估单一使用艾瑞布林或者同其它疗法结合，治疗三阴性乳腺癌患者的效果；研究者也希望可以尽快阐明艾瑞布林在治疗乳腺癌其它亚型中的作用，尤其是针对早期乳腺癌的治疗，这或许对于后期开发治疗乳腺癌，尤其是转移性乳腺癌的新型靶向疗法将提供更多的研究思路。（转化医学网360zhyx.com）
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转化医学网推荐的原文阅读：

Phase III Open-Label Randomized Study of Eribulin Mesylate Versus Capecitabine in Patients With Locally Advanced or Metastatic Breast Cancer Previously Treated With an Anthracycline and a Taxane
JCO doi: 10.1200/JCO.2013.52.4892
Peter A. Kaufman⇑, Ahmad Awada, Chris Twelves, Louise Yelle, Edith A. Perez, Galina Velikova, Martin S. Olivo, Yi He, Corina E. Dutcus and Javier Cortes
Purpose This phase III randomized trial (ClinicalTrials.gov identifier: NCT00337103) compared eribulin with capecitabine in patients with locally advanced or metastatic breast cancer (MBC).
Patients and Methods Women with MBC who had received prior anthracycline- and taxane-based therapy were randomly assigned to receive eribulin or capecitabine as their first-, second-, or third-line chemotherapy for advanced/metastatic disease. Stratification factors were human epidermal growth factor receptor-2 (HER2) status and geographic region. Coprimary end points were overall survival (OS) and progression-free survival (PFS).
Results Median OS times for eribulin (n = 554) and capecitabine (n = 548) were 15.9 and 14.5 months, respectively (hazard ratio [HR], 0.88; 95% CI, 0.77 to 1.00; P = .056). Median PFS times for eribulin and capecitabine were 4.1 and 4.2 months, respectively (HR, 1.08; 95% CI, 0.93 to 1.25; P = .30). Objective response rates were 11.0% for eribulin and 11.5% for capecitabine. Global health status and overall quality-of-life scores over time were similar in the treatment arms. Both treatments had manageable safety profiles consistent with their known adverse effects; most adverse events were grade 1 or 2.
Conclusion In this phase III study, eribulin was not shown to be superior to capecitabine with regard to OS or PFS.