内容紹介
Summary
Aim: We investigated the efficacy and safety of preoperative neoadjuvant chemotherapy(NAC)with a nanoparticle albumin-bound paclitaxel(nab-PTX)-containing regimen. Patients and methods: Twenty-eight female patients with StageⅠ-Ⅲ breast cancer received nab-PTX(260 mg/m2,q3w)±trastuzumab followed by FEC(5-fluorouracil 500 mg/m2 plus epirubicin 75 or 100 mg/m2 plus cyclophosphamide 500 mg/m2: q3w)between June 2013 and January 2015. Patients with HER2-positive breast cancer received trastuzumab concurrently with nab-PTX. Clinical response, pathological complete response(pCR), and adverse events were evaluated. Results: The overall pCR rate was 32%. The pCR rates for each subtype were as follows: HER2-type 86%, Luminal B-HER2 20%, triple-negative 17%, and Luminal B 0%. HER2-type breast cancer demonstrated the best response to this regimen. The clinical response rate for nab-PTX was 64%(18/28), and the safety profile was tolerable. Conclusion: nab-PTX±trastuzumab followed by FEC as NAC is effective and safe for operative breast cancer, especially HER2-type breast cancer.
要旨
目的: 当院における術前化学療法(neoadjuvant chemotherapy: NAC)としてのnanoparticle albumin-bound paclitaxel(nab-PTX)の有効性と安全性について後方視的に検討した。対象および方法: 2013年6月～2015年1月に当院でNACとしてnab-PTX(260 mg/m2,q3w)±trastuzumab followed by 5-FU+epirubicin+cyclophosphamide(FEC)を施行した原発性乳癌28例を対象とし,臨床効果,病理学的完全奏効(pathological complete response: pCR)率と有害事象を評価した。結果: subtypeはLuminal B(LB)type 5例,Luminal B-HER2(LB-HER2)type 10例,HER2 type 7例,triple negative(TN)type 6例。nab-PTXの奏効率は64%で,特にHER2 typeにおいては全例が奏効を示した。pCR率は32%で,subtype別ではLB type 0%(0/5),LB-HER2 type 20%(2/10),HER2 type 86%(6/7),TN type 17%(1/6)で,特にHER2 typeで良好な結果であった。nab-PTXの有害事象はGrade 3以上の好中球減少を29%に認めたが,発熱性好中球減少症は認めなかった。感覚性末【梢】神経障害は全Gradeで93%に認めたが,Grade 3は1例(4%)のみであった。結語: NACとしてのnab-PTX±trastuzumab followed by FECは忍容性が高く,PTXやdocetaxelの標準レジメンと同等の奏効率を,特にHER2陽性乳癌には高いpCR率を期待できる薬剤と考えられた。
目次
Aim: We investigated the efficacy and safety of preoperative neoadjuvant chemotherapy(NAC)with a nanoparticle albumin-bound paclitaxel(nab-PTX)-containing regimen. Patients and methods: Twenty-eight female patients with StageⅠ-Ⅲ breast cancer received nab-PTX(260 mg/m2,q3w)±trastuzumab followed by FEC(5-fluorouracil 500 mg/m2 plus epirubicin 75 or 100 mg/m2 plus cyclophosphamide 500 mg/m2: q3w)between June 2013 and January 2015. Patients with HER2-positive breast cancer received trastuzumab concurrently with nab-PTX. Clinical response, pathological complete response(pCR), and adverse events were evaluated. Results: The overall pCR rate was 32%. The pCR rates for each subtype were as follows: HER2-type 86%, Luminal B-HER2 20%, triple-negative 17%, and Luminal B 0%. HER2-type breast cancer demonstrated the best response to this regimen. The clinical response rate for nab-PTX was 64%(18/28), and the safety profile was tolerable. Conclusion: nab-PTX±trastuzumab followed by FEC as NAC is effective and safe for operative breast cancer, especially HER2-type breast cancer.
要旨
目的: 当院における術前化学療法(neoadjuvant chemotherapy: NAC)としてのnanoparticle albumin-bound paclitaxel(nab-PTX)の有効性と安全性について後方視的に検討した。対象および方法: 2013年6月～2015年1月に当院でNACとしてnab-PTX(260 mg/m2,q3w)±trastuzumab followed by 5-FU+epirubicin+cyclophosphamide(FEC)を施行した原発性乳癌28例を対象とし,臨床効果,病理学的完全奏効(pathological complete response: pCR)率と有害事象を評価した。結果: subtypeはLuminal B(LB)type 5例,Luminal B-HER2(LB-HER2)type 10例,HER2 type 7例,triple negative(TN)type 6例。nab-PTXの奏効率は64%で,特にHER2 typeにおいては全例が奏効を示した。pCR率は32%で,subtype別ではLB type 0%(0/5),LB-HER2 type 20%(2/10),HER2 type 86%(6/7),TN type 17%(1/6)で,特にHER2 typeで良好な結果であった。nab-PTXの有害事象はGrade 3以上の好中球減少を29%に認めたが,発熱性好中球減少症は認めなかった。感覚性末【梢】神経障害は全Gradeで93%に認めたが,Grade 3は1例(4%)のみであった。結語: NACとしてのnab-PTX±trastuzumab followed by FECは忍容性が高く,PTXやdocetaxelの標準レジメンと同等の奏効率を,特にHER2陽性乳癌には高いpCR率を期待できる薬剤と考えられた。