内容紹介
Summary
Several cases of hormone receptor-positive HER2-negative advanced and recurrent breast cancer treated with fulvestrant(FUL)were retrospectively investigated to assess the efficacy and safety of the treatment. FUL was administered to a total of 41 patients-33 with recurrent and 8 with Stage Ⅳ cancer-from January 2012 to September 2016. The median number of lines that used FUL was 3, the median time to treatment failure(TTF)was 7 months, the overall response rate(RR)was 19.5%, and the clinical benefit rate(CBR)was 53.6%. Our result was similar to those of the FIRST and the FALCON studies, which showed a decrease in RR after the fourth-line. With regard to RR, FUL seemed to provide better results at≤third-lines of treatment. While a shorter TTF was seen in the cases with liver metastases, a longer TTF was seen in the cases with soft tissue metastases. Therefore, it may be helpful to consider the site of metastasis when predicting the effects of FUL.
要旨
2012年1月～2016年9月までに当院でフルベストラント(fulvestrant: FUL)投与を開始したホルモン受容体陽性HER2陰性進行・再発乳癌41例(再発33例,Stage Ⅳ 8例)について,内分泌療法のline数と効果を中心に後方視的に検討した。FULを使用したline数は中央値で3,治療成功期間(time to treatment failure: TTF)は中央値で7か月,全体の奏効率(response rate: RR)19.5%,臨床的有用率(clinical benefit rate: CBR)は53.6%であった。 RRはthird-lineまでは25%であり,fourth-line以降では11.1%と低下を認め,first-lineの内分泌療法としてFUL 500 mgを使用したFIRST試験,FALCON試験の結果と同様に,よりup frontでの使用が望ましいと思われた。肝転移症例ではTTFが有意に短く,軟部組織(皮膚,リンパ節)のみの転移ではTTFは有意に長く,転移部位がFULの効果予測因子になり得ると考えられた。
目次
Several cases of hormone receptor-positive HER2-negative advanced and recurrent breast cancer treated with fulvestrant(FUL)were retrospectively investigated to assess the efficacy and safety of the treatment. FUL was administered to a total of 41 patients-33 with recurrent and 8 with Stage Ⅳ cancer-from January 2012 to September 2016. The median number of lines that used FUL was 3, the median time to treatment failure(TTF)was 7 months, the overall response rate(RR)was 19.5%, and the clinical benefit rate(CBR)was 53.6%. Our result was similar to those of the FIRST and the FALCON studies, which showed a decrease in RR after the fourth-line. With regard to RR, FUL seemed to provide better results at≤third-lines of treatment. While a shorter TTF was seen in the cases with liver metastases, a longer TTF was seen in the cases with soft tissue metastases. Therefore, it may be helpful to consider the site of metastasis when predicting the effects of FUL.
要旨
2012年1月～2016年9月までに当院でフルベストラント(fulvestrant: FUL)投与を開始したホルモン受容体陽性HER2陰性進行・再発乳癌41例(再発33例,Stage Ⅳ 8例)について,内分泌療法のline数と効果を中心に後方視的に検討した。FULを使用したline数は中央値で3,治療成功期間(time to treatment failure: TTF)は中央値で7か月,全体の奏効率(response rate: RR)19.5%,臨床的有用率(clinical benefit rate: CBR)は53.6%であった。 RRはthird-lineまでは25%であり,fourth-line以降では11.1%と低下を認め,first-lineの内分泌療法としてFUL 500 mgを使用したFIRST試験,FALCON試験の結果と同様に,よりup frontでの使用が望ましいと思われた。肝転移症例ではTTFが有意に短く,軟部組織(皮膚,リンパ節)のみの転移ではTTFは有意に長く,転移部位がFULの効果予測因子になり得ると考えられた。