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DUM SPIRO-SPERO Forum Onkologiczne Strona Główna

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DUM SPIRO-SPERO Forum Onkologiczne Strona Główna
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  Temat: Rak piersi - przerzuty do kości
zosia bluszcz

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Wyświetleń: 83590

PostDział: Nowotwory piersi i ginekologiczne   Wysłany: 2009-09-08, 11:02   Temat: Potrojnie negatywny rak piersi - leczenie
1. PACLITAXEL + AVASTIN (bevacizumab) vs PACLITAXEL
Terapia kombinowana daje lepsze wyniki w leczeniu potrojnie negatywnego raka piersi - PFS (progression free survival = przezycie bez progresji) rosnie srednio z 5,9 miesiaca przy samym Paclitaxelu do 11,8 m przy terapii kombinowanej.

 Antiangiogenic Agents—The antiangiogenic agent bevacizumab (Avastin), a monoclonal antibody targeting all forms of vascular endothelial growth factor (VEGF)-A, is active in a variety of solid tumors including breast cancer. The landmark study E2100 illustrated improvement in progression-free survival (11.8 vs 5.9 months, HR = 0.60, P < .001) when adding bevacizumab to paclitaxel chemotherapy compared with single-agent paclitaxel alone in first-line treatment of metastatic disease. Subset analyses indicated that the treatment effect persisted among ER/PR–negative patients (HR = 0.53, 95% confidence interval = 0.40–0.70) in this largely (> 90%) HER2-negative patient population.[60] Additionally, small-molecule inhibitors of the VEGF pathway appear to have activity in the subset of pretreated triple-negative breast cancer; definitive studies are underway.
http://www.cancernetwork....27?pageNumber=3

2. XELODA (capecitabine) + IXEMPRA (ixabepilne) vs XELODA

Kombinacja Xeloda + Ixempra daje lepsze wyniki niz Xeloda stosowana solo przy opornym na leczenie potrojnynie negatywnym raku piersi - takie wnioski plyna z proby klinicznej 3 stopnia, podczas ktorej z grupy 752 pacjentek wyloniono podgrupe 187 kobiet z potrojnie negatywnym, odpornym na chemie rakiem. U 27% pacjentek leczenie terapia kombinowana dalo efekty - sredni PFS = 4,1 miesiaca

January 1, 2008
Oncology NEWS International. Vol. 17 No. 1 1146846
Focus on Breast Cancer
Xeloda/Ixempra effective in resistant triple-negative ca

SAN ANTONIO—The combination of capecitabine (Xeloda) and ixabepilone (Ixempra) appears to be robust in patients with the so-called triple-negative breast cancer phenotype, according to an analysis of a predefined subset of the larger 752-patient phase III trial of the combination vs capecitabine alone.

In 187 heavily pretreated metastatic breast cancer patients with the triple-negative subtype, the regimen yielded an overall response rate of 27% and median progression-free survival (PFS) of 4.1 months, Hope Rugo, MD, of the University of California, San Francisco, reported at the 2007 San Antonio Breast Cancer Symposium (abstract 6069).

"This study was an attempt to cull out this very resistant group of patients, which represented 25% of patients in our larger trial. These patients have limited treatment options, and this was quite an effective treatment for them," Dr. Rugo commented.

An aggressive phenotype

Triple-negative breast cancer is characterized by tumors that are estrogen-receptor (ER) negative, progesterone-receptor (PR) negative, and HER2 negative. This is an aggressive phenotype with poor prognosis as a result of its increased mitotic index, central necrosis, proportion of apoptotic cells, and other high-risk pathological features.

Patients with triple-negative tumors develop their disease at an earlier age, are more likely to relapse, and tend to develop visceral and brain metastases as well as bone metastases, compared with other breast cancer subtypes, Dr. Rugo noted.

"Most importantly, such patients have worse survival, compared with other subgroups, and have fewer effective treatment options, since they are not candidates for either hormonal or HER2-targeted therapy," she said.
http://www.cancernetwork..../article/10165/
 
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