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Clin cancer Res：依维莫司是否对II / III期乳腺癌患者有益？

2017-03-11 MedSci MedSci原创

依维莫司乳腺癌
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由于疾病的固有异质性，II / III期三阴性乳腺癌（TNBC）患者的治疗已经排除了靶向治疗，但是，目前尚未鉴定除能够预测治疗反应的生物标志物。近期，一项发表在杂志Clin cancer Res上的研究旨在确定mTOR抑制剂依维莫司与顺铂和紫杉醇是否能够在TNBC中提供协同抗肿瘤的作用。此项研究招募了II期/ III期TNBC患者参加了术前每周顺铂，紫杉醇和每日依维莫司或安慰剂的为期12周的随机I

由于疾病的固有异质性，II / III期三阴性乳腺癌（TNBC）患者的治疗已经排除了靶向治疗，但是，目前尚未鉴定除能够预测治疗反应的生物标志物。


近期，一项发表在杂志Clin cancer Res上的研究旨在确定mTOR抑制剂依维莫司与顺铂和紫杉醇是否能够在TNBC中提供协同抗肿瘤的作用。

此项研究招募了II期/ III期TNBC患者参加了术前每周顺铂，紫杉醇和每日依维莫司或安慰剂的为期12周的随机II期试验，直到确定手术。在基线，周期1和手术时获得肿瘤标本。主要终点是病理完全反应（pCR）;次要终点包括临床反应，乳腺残存率，安全性和与结果相关的分子特征的发现。

此项研究结果显示：自2009年至2013年，共有145例患者参与；在依维莫司组中36％的患者和在安慰剂组中的49％的患者实现了pCR；在每个组中，50％的患者在影像学上获得了完全反应。

在依维莫司组中观察到较高的中性粒细胞减少，粘膜炎和转氨酶升高的速率。对治疗的临床反应和长期结果与DNA损伤反应（DDR）基因突变，基底样1和间充质TNBC-亚型，AR阴性状态和高Ki67频率增加，但不与肿瘤浸润淋巴细胞的增加相关。

此项研究表明：紫杉醇/顺铂组合具有良好的耐受性和活性，但是依维莫司的使用与更多不良事件相关，而pCR或临床反应并没有改善。

原始出处：

Jovanovic B, Mayer IA, et al. A randomized phase II neoadjuvant study of cisplatin, paclitaxel with or without everolimus in patients with stage II/III triple-negative breast cancer (TNBC). Clin Cancer Res. 2017 Mar 7. pii: clincanres.3055.2016. doi: 10.1158/1078-0432.CCR-16-3055.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1915938, encodeId=c4bf1915938e2, content=<a href='/topic/show?id=c5a89550ff' target=_blank style='color:#2F92EE;'>#III#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9550, encryptionId=c5a89550ff, topicName=III)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Tue Oct 31 18:32:00 CST 2017, time=2017-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=179911, encodeId=ef561e991120, content=学习了，多谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Tue Mar 14 23:44:16 CST 2017, time=2017-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=179584, encodeId=d9881e95843c, content=很好的学习资料，谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Mar 13 13:18:06 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571023, encodeId=762b15e10230d, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Mon Mar 13 05:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594472, encodeId=abfa15944e2b2, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Mon Mar 13 05:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=179149, encodeId=75651e9149f6, content=最新研究，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0LqDY57Aia0TOQByoJhNt3icm4sfukp500hLH6RHOpFdV01NbECtAV7s0qKpQPibyRukQAwAmqJU3X/0, createdBy=f91f1928792, createdName=九九消寒, createdTime=Sat Mar 11 15:34:48 CST 2017, time=2017-03-11, status=1, ipAttribution=)]
    2017-10-31 juliusluan78

    #III#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1915938, encodeId=c4bf1915938e2, content=<a href='/topic/show?id=c5a89550ff' target=_blank style='color:#2F92EE;'>#III#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9550, encryptionId=c5a89550ff, topicName=III)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e68e415, createdName=juliusluan78, createdTime=Tue Oct 31 18:32:00 CST 2017, time=2017-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=179911, encodeId=ef561e991120, content=学习了，多谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=84e21956153, createdName=1e1263e3m20(暂无匿称), createdTime=Tue Mar 14 23:44:16 CST 2017, time=2017-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=179584, encodeId=d9881e95843c, content=很好的学习资料，谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Mar 13 13:18:06 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571023, encodeId=762b15e10230d, content=<a href='/topic/show?id=f42823e48d7' target=_blank style='color:#2F92EE;'>#乳腺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23748, encryptionId=f42823e48d7, topicName=乳腺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=37bc15724202, createdName=hanhaisha2013, createdTime=Mon Mar 13 05:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594472, encodeId=abfa15944e2b2, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Mon Mar 13 05:32:00 CST 2017, time=2017-03-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=179149, encodeId=75651e9149f6, content=最新研究，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0LqDY57Aia0TOQByoJhNt3icm4sfukp500hLH6RHOpFdV01NbECtAV7s0qKpQPibyRukQAwAmqJU3X/0, createdBy=f91f1928792, createdName=九九消寒, createdTime=Sat Mar 11 15:34:48 CST 2017, time=2017-03-11, status=1, ipAttribution=)]
    2017-03-14 1e1263e3m20(暂无匿称)

    学习了，多谢分享

    0

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    2017-03-13 虈亣靌

    很好的学习资料，谢谢了。

    0

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    2017-03-13 hanhaisha2013

    #乳腺癌患者#

    0

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    2017-03-13 智智灵药

    #III期#

    0

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    2017-03-11 九九消寒

    最新研究，学习了

    0

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