The Efficacy And Safety Of Perpetrated Combined With Platinum In Patients For Advanced Breast Cancer

Objective:To retrospectively analyze the efficacy and safety of pemetrexed combined with platinum chemotherapy in patients with advanced breast cancer.Methods:A total of 113 patients with advanced breast cancer who were admitted to the Affiliated Tumor Hospital of Guangxi Medical University from December 2010 to December 2016 were enrolled.All patients received pemetrexed plus cisplatin/carboplatin regimen,pemetrexed(500mg/m2,dl),cisplatin(25mg/m2,dl-3),21 days as a cycle.Primary research aims:Objective Response Rate(ORR),Progression-free Survival(PFS),Secondary research aims:Disease Control Rate(DCR),Overall Survival(OS)and Safety.Survival analysis was performed by the positive rate limit method(Kaplan-Meier method)and log-rank test.Chi-square test and Fisher exact probability method were used to compare ORR and DCR between groups.Cox proportional hazard regression model was used for prognosis analysis.The difference was considered statistically significant when P<0.05.Results:1.All patients can be evaluated for toxic and side effects,of which 103 patients can be evaluated for efficacy.1 patient get complete response(CR),27 patients of partial remission(PR),43 patients of stable(SD),35 patients of progression(PD),overall objective response rate(ORR)26.4%,disease Control rate(DCR)67%.Median progression-free survival(mPFS)5.3 months,median survival(mOS)15.8 months.2.The ORR of first-line treatment,second-line treatment,third-line and third-line treatment were 38.4%,27.3%,20.5%,respectively.The DCR was 76.9%,72.8%,61.4%,respectively.The mPFS was 6.7 months,7.1 months,3.7 months,respectively.There were no significant differences in ORR,DCR and PFS between the two groups(P>0.05).The mOS were 19.3 months,21.8 months and 11.1 months,respectively,and the difference between the three groups was statistically significant(P=0.028).3.Subgroup analysis showed that the ORR of pemetrexed plus carboplatin(N=71)and pemetrexed plus cisplatin(N=32)were 28.2%and 25%,respectively,and the DCR was 67.6%and 71.9%,respectively.mPFS was 4.7 months and 5.8 months,respectively,and mOS was 15.2 months and 14.5 months,respectively.There was no significant difference in ORR,DCR,PFS and OS between the two groups(P>0.05).4.Univariate analysis showed that Ki-67,the number of organ metastases and the presence or absence of visceral metastasis are associated with PFS,and the ECOG Performance Status,the number of organ metastases and line of treatment are associated with OS(P<0.05).Multivariate analysis showed that ECOG PS was correlated with OS(P<0.05).5.There are 103 patients can be evaluate the efficacy,53 patients had no progression after pemetrexed combined with platinum-based chemotherapy,39 of whom underwent maintenance therapy and 14 did not receive maintenance therapy.The mPFS of maintenance and untreated patients were 11.2 months and 7.5 months,respectively,and mOS were 24.1 months and 10.1 months,respectively,and the difference was statistically significant(P<0.05).6.All patients can be evaluated for toxic and side effects,the grades 3/4 hematologic toxicity were anemia(9.7%),leukopenia(4.4%),neutrophil reduction 1.8%,and thrombocytopenia(5.3%).The grades 3/4 Non-hematologic toxicity nausea and vomiting(1.8%),transaminase(2.7%),and no treatment-related death.Pemetrexed combined with cisplatin group in 34 cases(31.9%),pemetrexed plus carboplatin group in 79 cases(68.1%),the incidence of nausea and vomiting in the DP group was significantly higher than the CP group(67.6%VS 34.2%),the difference was statistically significant(P=0.003).The incidence of hematologic toxicity was 70.6%and 65.8%,respectively,and the difference was not statistically significant(P>0.05).Conclusion:1.Pemetrexed combined with platinum regimen is effective in the treatment of advanced breast cancer,and the adverse reactions are mild.2.Patients received pemetrexed combination with platinum chemotherapy and achieved disease stabilization or response continued receiving maintenance therapy,can prolong the progression free survival and the overall survival.3.There is no significant difference between pemetrexed combined with cisplatin and pemetrexed combined with carboplatin in the treatment of advanced breast cancer,but the incidence of nausea and vomiting in the former is higher.