| Background:The incidence and mortality of breast cancer,the most common cancer of global female,tend to increase in recent years.Above all,advanced breast cancer has seriously harmed the physical and mental health of patients.It is a pity that most patients with advanced breast caner are antharcycline and taxane resistant,resulting in the insufficiency of therapeutic methods,bad prognosis and decline of life quality.A lot scientific research personnel and clinicians have high attention of this problem.The chemotherapy regiment of pemetrexed combined with cisplatin/carboplatin has shown obvious antineoplastic effects in other solid tumor.Objective:To investigate the clinical efficacy and safety of pemetrexed combined with cisplatin/carboplatin in third-line and above advanced breast cancer patients.To explore the factors that affect the prognosis of patients with advanced breast cancer.Methods:Pemetrexed combined with cisplatin/carboplatin was used in 72 third-line and above advanced breast cancer patients with chemotherapy resistance to anthracyclines and taxanes hospitalized from January 1,2017 to November 1,2010.We restrospectively analysed the data of these patients collected from the department of oncology and breast surgery of the First Affiliated Hospital of Zhengzhou University.To investigate the efficacy,safety and prognostic factors of pemetrexed combined with cisplatin/carboplatin in the treatment of advanced breast cancer patients.Results:1.Short-term efficacy and prognostic factors:0 patients(0%)received CR in 72 patients.There were 12 patients with PR,accounting for 16.67%(12/72).37 SD patients were maintained,accounting for 51.39%(37/72);There were 23 patients with PD,accounting for 31.94%(23/72).There were 12 patients with objective efficacy,49 patients with disease control,ORR was 16.67%(12/72),and DCR was 68.06%(49/72).The results of single factor analysis showed that ECOG score,Her2 type and number of metastatic sites were independent influencing factors of ORR in patients,while Her-2 type and number of metastatic sites were independent influencing factors of DCR in patients.2.Long-term efficacy and prognostic factors:Kaplan-Meier method was used to estimate the mPFS of 72 patients at 4.5 months(95%CI,2.5-6.5 months),mOS at 19.3 months(95%CI,10.8-26 months),and 1-year and 2-year survival rates at 69.0%and 49.3%,respectively.Survival data were analyzed after grouping patients' baseline characteristics,and then the obtained data were tested by log-rank test.The results showed that Her-2 type,number of metastatic sites and the experience of endocrine therapy would affect the survival of patients.In the multivariate Cox regression analysis,Her-2 type(p=0.0051)and the number of metastatic sites(p=0.0189)were independent prognostic factors affecting PFS.3.Adverse reactions:most of them are moderate(grade 1 to 2),which can be relieved or tolerated after treatment.Conclusion:1.The combination of pemetrexed and cisplatin/carboplatin regimen has obvious anti-tumor effect on third-line advanced breast cancer patients with anthracyclines and taxanes resistance,and the adverse reactions are tolerable;2.ECOG score,Her-2 type and number of metastatic sites were independent influencing factors of ORR and DCR of patients;Age,menstrual status,pathological type,hormone receptor type,molecular typing,presence or absence of visceral metastasis,and previous endocrine therapy had nothing to do with the curative effect and prognosis of patients.3.The type of her-2,the number of metastatic sites and the presence or absence of endocrine therapy will affect the survival of patients;Her-2 type(p-00051)and the number of metastatic sites(p=00189)were independent prognostic factors of PFS. |
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