Curative Effect Observation Of GP Regimen In The Treatment Of Advanced Triple-Negative Breast Cancer

ObjectiveTo study the clinical efficacy and adverse reactions of GP regimen in advanced TNBC,and analyze whether there are differences in curative effect and adverse reaction in three aspects: line level,past treatment and maintenance therapy.MethodsA retrospective analysis of 46 patients with advanced TNBC who were treated with GP regimen chemotherapy in the first internal department of Liaoning Provincial Oncology Hospital in the period from June 2014 to June 2018 was carried out.The evaluation criteria for the efficacy of solid tumor were used to evaluate the curative effect.The effective rate(RR),disease control rate(DCR)and median progression-free survival time(mPFS)in patients with advanced TNBC after chemotherapy with GP regimen was statistically analyzed in three aspects: treatment line level,past treatment status,and maintenance therapy.Adverse reactions were evaluated using the common toxicity criteria developed by the National Cancer Institute.IBM SPSS Statistics 23 software was used for statistical analysis.ResultsThe short-term curative effect was evaluated in 46 patients who received GP regimen chemotherapy,14(30.4%)patients with PR,17(37.0%)patients with SD,15(32.6%)patients with PD,without CR patients.RR and DCR were 30.4% and 67.4%,respectively.26 received first-line chemotherapy.After treatment,10(38.5%)patients with PR and 38.5%(38.5%)patients with SD,6(23.0%)patients had PD,RR and DCR were 38.5% and 77.0%,respectively.20 patients received second-line chemotherapy,4(20.0%)patients with PR,7(35.0%)patients with SD,9(45.0%)with PD,RR and DCRwere 20.0% and 55.0%,respectively.There was no significant difference in the short term curative effect of the first and second line chemotherapy patients.(P > 0.05).According to the past treatment,5 patients were treated with anthracycline chemotherapy,2(40.0%)patients with PR,2(40.0%)patients with SD,1(20.0%)patients with PD,RR and DCR were 40.0% and 80.0%,respectively.There were 7cases of taxanes chemotherapy,1(14.2%)cases with PR,3(42.9%)with SD,3(42.9%)cases with PD.RR and DCR were 14.2% and 57.1%,respectively.Among the patients treated with anthracycline and taxanes,10(31.2%)were PR,11(34.4%)were SD,11(34.4%)were PD.RR and DCR were 31.2% and 65.6%,respectively.There were only 2 patients who had not received any previous treatment,1(50.0%)patients with PR,1(50%)patients with SD.RR and DCR were 50% and 100%,respectively.There was no significant difference in the short-term efficacy of patients receiving different treatments(P > 0.05).The median PFS of 46 patients after treatment was 191 days(95% CI:135.611~246.389).Compared between different line levels,the first-line treatment group obtained 236 days of mPFS(95% CI: 162.294~309.706).The mPFS of the second line treatment group was 135 days(95% CI: 53.920~216.080),there was a significant difference(P = 0.045).The long-term outcomes of 25 patients who had not progressed after 6-cycle rescue chemotherapy with GP regimen were analyzed.The mPFS was 255 days(CI:240.312~269.688),of which 14(56%)received maintenance therapy,11(44%)patients did not receive maintenance therapy.The mPFS of maintenance treatment group was 268 days(95% CI: 223.998~312.002),and that of non-maintenance treatment group was 215 days(95% CI: 140.553~289.447).The difference was statistically significant(P=0.012).The incidence of nausea and vomiting and fatigue were 80.4% and 73.9%respectively,followed by bone marrow suppression,mainly manifested as thrombocytopenia in 33 cases(71.7%)and leukopenia in 32 cases(69.6%).32 cases(69.6%)had anemia;There were 5 cases(10.9%)with liver dysfunction,most of which were grade ? and ?,and 2 patients(4.3%)were stopped because of adverse reactions.There was no significant difference in the incidence of adverse reactions between first line and second line treatment(P > 0.05).Conclusion1.GP regimen has a good therapeutic effect in advanced TNBC patients.It's tolerable.2.There is a significant improvement of mPFS by using maintenance therapy.In a word,this regimen is effective in the treatment of advanced TNBC patients with mild side effects.Therefore,GP regimen is worth popularizing in the rescue treatment of advanced TNBC patients.