贝伐单抗在乳腺癌治疗中的疗效和风险评估

摘要/Abstract

摘要： 近年来贝伐单抗在乳腺癌治疗中备受争议。尽管E2100研究结果提示贝伐单抗联合化疗能使无进展生存期(PFS)提高一倍,但是之后的其他研究并没有重复该试验结果,各个独立研究和荟萃分析提示贝伐单抗联合化疗方案不能提高总生存期(OS)。美国FDA于2011年11月以贝伐单抗未能延长转移性乳腺癌患者的总生存期为理由撤销了其乳腺癌适应症的许可。另外,使用贝伐单抗可能发生严重的不良反应,如高血压、充血性心力衰竭和血栓等。因此,在全球范围内使用该药物需考虑其效价比,并对疗效和风险进行重新评估。未来的研究方向是以生物标记为基础,以筛选出能从贝伐单抗治疗中获益的乳腺癌人群。

关键词: 乳腺肿瘤, 血管内皮细胞生长因子, 贝伐单抗, 疗效, 风险

Abstract: Recently, bevacizumab in the treatment of advanced breast cancer is controversial. Although the E2100 had doubled the progression-free survival when bevacizumab was added to chemotherapy, this magnitude of benefit could not be replicated in subsequent studies. Furthermore, individual studies and meta-analyses failed to demonstrate an overall survival benefit with the addition of bevacizumab to different chemotherapy regimens. The US FDA has withdrawn the approval of bevacizumab as a therapeutic option for the treatment of metastatic breast cancer in November, 2011; because that it cannot prolong the overall survival time. In addition, this agent is associated with an increased incidence of serious adverse events such as hypertension, congestive heart failure and thromboembolism, and its cost is likely to be a consideration in its use worldwide. Reevaluation of the benefit-versus-risk is indispensable. Biomarker-based studies aiming to identify the subpopulation of patients most likely to benefit from the addition of bevacizumab to standard chemotherapy in breast cancer should be a research priority in future.

Key words: Breast tumor, Vascular endothelial growth factor, Bevacizumab, Benefit, Risk

中图分类号:

R737.9

王升晔, 杜向慧. 贝伐单抗在乳腺癌治疗中的疗效和风险评估[J]. 中国临床药理学与治疗学, 2013, 18(1): 115-120.

WANG Sheng-ye, DU Xiang-hui. Benefit-risk Evaluation of Bevacizumab in the treatment of Breast Cancer[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(1): 115-120.

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