Hormon reseptör pozitif HER2-negatif metastatik meme kanseri tedavisinde üçüncü ve sonraki basamaklarda everolimus/eksemestan tedavisinin etkinliği ve toksisitesi

Year 2020, , 443 - 446, 01.06.2020

Fatih Yıldız , Berna Öksüzoğlu

https://doi.org/10.28982/josam.745731

Cited By: 1

Abstract

Amaç: Siklin bağımlı kinaz 4-6 inhibitörü ve fulvestrant gibi tedavilerin tek başına ya da kombinasyon halinde kullanılmasının hormone reseptör (HR)-pozitif metastatik meme kanseri (MMK) tedavisinde daha etkin olduğunun gösterilmesiyle günlük pratikte everolimus/eksemestan tedavisi daha ileriki basamaklarda kullanılmaya başlamıştır. Bu çalışmanın amacı HR-pozitif HER2-negatif MMK tedavisinde üçüncü ve sonraki basamaklarda everolimus/eksemestan kombinasyon tedavisinin etkinliğini ve toksisitelerini gerçek yaşam verileri ile değerlendirmektir.
Yöntemler: Bu çalışma retrospektif kohort çalışmasıdır. Kasım 2013 - Mart 2020 tarihleri arasında merkezimizde HR-pozitif HER2-negatif MMK tanısıyla everolimus/eksemestan kombinasyon tedavisi alanlar çalışmaya dahil edilmiştir. Hastaların klinikopatolojik özellikleri ve tedavi ilişkili toksisiteler retrospektif olarak incelenmiştir.
Bulgular: Çalışmaya dahil edilen 33 hastanın ortanca yaşı 59’du (30-77). Hastaların 23’ünün (%69,7) visseral metastazı varken 10 (%30,3) hastanın yalnızca kemik metastazı vardı. Everolimus/eksemestan tedavisi 22 (%66,6) hastaya üçüncü basamakta, 11 (%33,3) hastaya ise sonraki basamaklarda verilmişti. Ortanca takip süresi 15.5 (0,3-35,5) aydı. Ortanca progresyonsuz sağkalım (PS) 7,0 (5,1-9,0, 95% CI) ay; ortanca genel sağkalım ise 21,3 (13,4-29,2, 95% CI) aydı. Yalnızca kemik metastazı olan hastalarla visseral metastazı olan hastalar arasında ortanca PS açısından fark yoktu (7,2–6,4 ay; P=0,96).
Sonuç: Everolimus/eksemestan kombinasyonu HR-pozitif HER2-negatif MMK tedavisinde ileriki basamaklarda da etkin ve tolere edilebilir bir tedavi seçeneğidir.

Keywords

Everolimus, Eksemestan, Meme kanseri

Efficacy and toxicity of everolimus plus exemestane in third and later lines treatment of hormone receptor-positive, HER2-negative metastatic breast cancer

Abstract

Aim: In daily practice, everolimus plus exemestane therapy has begun to be used in the later-lines as it has been demonstrated that treatments such as cyclin-dependent kinase (CDK) 4/6 inhibitors and fulvestrant, alone or in combination, are more effective in hormone receptor (HR)-positive metastatic breast cancer (MBC). The aim of this study is to evaluate the efficacy and toxicity of everolimus plus exemestane in the third line and later-lines on HR-positive Human Epidermal Growth Factor Receptor 2 (HER2)-negative MBC treatment with real-life data.
Methods: Patients who received everolimus plus exemestane with the diagnosis of HR-positive and HER2-negative MBC between November 2013 and March 2020 were included in this retrospective cohort study. Clinicopathological characteristics of patients and treatment related toxicities were evaluated retrospectively.
Results: The median age of the 33 patients included in the study was 59 (30-77) years. Twenty-three (69.7%) of the patients had visceral metastasis, while 10 (30.3%) had only bone metastasis. Everolimus plus exemestane was used in the third line in 22 (66.6%) patients and later-lines in 11 (33.3%) patients. The median follow-up time was 15.5 months (0.3-35.5). Median progression-free survival (PFS) and overall survival (OS) were 7.0 (5.1-9.0, 95% CI) months and 21.3 (13.4-29.2, 95% CI) months, respectively. Median PFS of patients with only bone metastasis and visceral metastasis were similar (7.2 vs 6.4 months, P=0.96).
Conclusion: Everolimus plus exemestane is an effective and tolerable treatment choice in the later-lines in the treatment of HR-positive HER2-negative MBC.

Keywords

Everolimus, Exemestane, Breast cancer

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