摘要
目的探讨中国HER2阳性早期乳腺癌患者采用曲妥珠单抗辅助治疗1年或不治疗中位随访1年的疗效和安全性。方法HERA研究为国际多中心、随机、开放Ⅲ期临床研究。入组患者为早期乳腺癌术后淋巴结阳性或高危淋巴结阴性,HER2阳性的女性,在完成了辅助或新辅助化疗、放疗(需要时)后随机接受曲妥珠单抗(商品名赫赛汀)辅助治疗1年、2年或观察(无赫赛汀治疗)。主要研究终点为无病生存时间,次要研究终点为总生存时间,无复发生存时间,无远处疾病生存时间,安全性和耐受性及心功能异常的发生率。2005年4月进行了首次计划的全球中期疗效分析,比较赫赛汀1年治疗组和观察组的疗效和安全性。本研究报告了数据库中中国入组病人的结果。结果中国8家中心的122例患者纳入全球的中期疗效分析。赫赛汀1年治疗组68例,观察组54例。中位随访1年时,赫赛汀治疗组与观察组分别发生3例和8例无病生存事件,两组2年无病生存率分别为92.9%和81.4%,绝对值提高11.5%,P=0.0489;赫赛汀治疗组与观察组2年无复发生存率分别为98.1%和81.4%,P=0.0064,无远处疾病生存率分别为98.1%和83.3%,P=0.0117。赫赛汀治疗的耐受性较好,未发现严重的心脏事件或新的安全性问题。结论赫赛汀辅助治疗1年可延长中国HER2阳性早期乳腺癌病人的2年无病生存时间、无复发生存时间和无远处疾病生存时间。
Objective To evaluate the efficacy and safety of 1-year adjuvant trastuzumab (herceptin) versus 1-year non-trastuzumab observation in Chinese patients with HER2-positive early breast cancer during a median follow-up of 1 year. Methods The HERA trim was an international, multicenter, randomized, open-label, phase m trial comparing treatment with trastuzumab for 1 and 2 years with observation after standard adjuvant chemotherapy, radiotherapy or both in patients with HER2-positive node- positive or high-risk node-negative early breast cancer. The primary endpoint w^s disease-free survival. Secondary end points included recurrence-free survival, distant disease-free survival, overall survival and cardiac safety. The first planned interim analysis comparing the efficacy and safety of treatment with trastuzumab for 1 year versus observation were completed in April 2005. Only the outcomes of recruited Chinese patients were reported. Results A total of 122 Chinese patients from 8 participating centers were included for planned interim analysis. And they were divided into trastuzumab ( n = 68 ) and observation (n =54) groups. Three and eight disease-free survival events were observed in the trastuzumab and observation groups respectively. Two-year disease-free survival rates were 92. 9% and 81.4% respectively (P = 0. 0489) ; 2-year recurrence-free survival and distant disease-free survivals were 98.1% vs 81.4% (P =0. 0064) and 98.1% vs 83.3% (P =0. 0117) respectively. Trastuzumab was generally well-tolerated with a decent safety profile. Severe cardiotoxieity was not observed. Conclusion One-year treatment with adjuvant trastuzumab improves disease-free survival, recurrence-free survival and distant disease-free survival in Chinese patients with HER2-positive early breast cancer.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第47期3345-3349,共5页
National Medical Journal of China