乳腺癌的化疗进展培训ppt课件

乳腺癌的化乳腺癌的化疗进展展乳腺癌的化疗进展1 1乳腺癌化疗的历史回顾70年代：CMF80年代：蒽环类（anthracyclines）90年代：紫杉类（taxanes)21世纪：化疗生物靶向治疗常规剂量密集 乳腺癌的化疗进展2乳腺癌化疗的历史回顾70年代：CMF乳腺癌的化疗进展2TX方案与AC方案比较docetaxel/capecitabine(TX)ADM/CTX(AC)目的：无蒽环类方案与含蒽环类方案比较。3期单中心随机试验。Lee KS,et al.Breast Cancer Res Treat.2007 乳腺癌的化疗进展3TX方案与AC方案比较docetaxel/capecitabTX方案与AC方案比较209 209 例腋窝淋巴结阳性，例腋窝淋巴结阳性，II/III II/III 期期BCBC行行4 4周期周期TX or TX or AC.AC.TXTX与与ACAC比比,增加了增加了 pCR(21%/10%,pCR(21%/10%,P=0.024)P=0.024)，RR(84%/65%,P=0.003).RR(84%/65%,P=0.003).TXTX恶心、呕吐少，但口腔炎、腹泻恶心、呕吐少，但口腔炎、腹泻,肌肉痛，皮肌肉痛，皮肤及指甲改变比肤及指甲改变比ACAC明显。明显。DFSDFS无差别无差别(P=0.932).(P=0.932).pCR pCR 者复发少者复发少(P=0.025;hazard ratio,0.189;(P=0.025;hazard ratio,0.189;95%CI,0.044-0.815).95%CI,0.044-0.815).Lee KS,et al.Breast Cancer Res Treat.2007 乳腺癌的化疗进展4TX方案与AC方案比较209 例腋窝淋巴结阳性，II/IIPhase III trial comparing AC with TCdoxorubicin and cyclophosphamide(AC)docetaxel and cyclophosphamide(TC)1016 例 AC(n=510)TC(n=506),every 3 weeks.完成化疗后给予放疗，受体阳性者给予 tamoxifen,Jones SE,et al.J Clin Oncol.2006;24(34):5381-5387.乳腺癌的化疗进展5Phase III trial comparing AC wPhase III trial comparing AC with TC结果:TC的 5年 DFS 明显高于AC(86%v 80%,P=0.015).ORR:TC/AC 90%/87%,P=0.13.肌肉痛、关节痛、水肿、粒细胞减少在TC组多见。恶心、呕吐，充血性心衰在AC组多见。Jones SE,et al.J Clin Oncol.2006;24(34):5381-5387.乳腺癌的化疗进展6Phase III trial comparing AC wA phase II trial of docetaxel as second-line A phase II trial of docetaxel as second-line chemotherapy in patients with MBCchemotherapy in patients with MBC docetaxel 100 mg/m(2)every 3 weeks RR:35%MS:12MMTTP:4Mdocetaxel 是治疗MBC的有效2线药物，特别是对 anthracycline耐药的病人。Baur M,et al.J Cancer Res Clin Oncol.2007 乳腺癌的化疗进展7A phase II trial of docetaxel Nab-paclitaxel(ABI-007,Abraxane)是将paclitaxel包裹在白蛋白里。Henderson IC,et al.Expert Rev Anticancer Ther.2007;7(7):919-943.Nab-paclitaxel for breast cancer:a new formulation with an Nab-paclitaxel for breast cancer:a new formulation with an improved safety profile and greater efficacyimproved safety profile and greater efficacy 乳腺癌的化疗进展8Henderson IC,et al.Expert ReNab-paclitaxel for breast cancer:a new formulation Nab-paclitaxel for breast cancer:a new formulation with an improved safety profile and greater efficacywith an improved safety profile and greater efficacy 随机 II 期临床试验提示 每周一次nab-paclitaxel 比每3周一次nab-paclitaxel或docetaxel更有效、更安全。nab-paclitaxel 的优势在于安全性提高，可以增加剂量，且进入肿瘤细胞内的药物比例更高。Henderson IC,et al.Expert Rev Anticancer Ther.2007;7(7):919-943.乳腺癌的化疗进展9Nab-paclitaxel for breast cancThe trastuzumab and vinorelbine or taxane study.The trastuzumab and vinorelbine or taxane study.此为一项前瞻性、多中心、随机对照研究。此为一项前瞻性、多中心、随机对照研究。方法方法:HER2:HER2过度表达的过度表达的 MBC MBC，未进行过化疗的，未进行过化疗的病人随机分为病人随机分为 trastuzumab trastuzumab vinorelbine vinorelbine 每周一次。每周一次。trastuzumab trastuzumab taxane taxane 每周一次。每周一次。结论结论:vinorelbine/trastuzumab:vinorelbine/trastuzumab 和和 taxane/trastuzumab taxane/trastuzumab 一线治疗一线治疗HER2HER2阳性的阳性的 MBC MBC疗效无差异疗效无差异。Burstein HJ,et al.Cancer.2007 乳腺癌的化疗进展10The trastuzumab and vinorelbinA phase-III trial of doxorubicin and docetaxel A phase-III trial of doxorubicin and docetaxel versus doxorubicin and paclitaxel in metastatic versus doxorubicin and paclitaxel in metastatic breast cancer:results of the ERASME 3 study.breast cancer:results of the ERASME 3 study.MBC患者随机分为AD 组或AP 组，每3周一次。AD4-docetaxel4 AP4-paclitaxel4Cassier PA,et al.Breast Cancer Res Treat.2007 乳腺癌的化疗进展11A phase-III trial of doxorubicA phase-III trial of doxorubicin and docetaxel A phase-III trial of doxorubicin and docetaxel versus doxorubicin and paclitaxel in metastatic versus doxorubicin and paclitaxel in metastatic breast cancer:results of the ERASME 3 study.breast cancer:results of the ERASME 3 study.结果结果:RR:39.6%for AD and 41.8%for AP.RR:39.6%for AD and 41.8%for AP.median PFS median PFS 和和 median OS median OS：8.7 M 8.7 M和和 21.4 M(AD)21.4 M(AD)；8.0M 8.0M 和和 27.3 M(AP)(p=0.977 and 0.081),27.3 M(AP)(p=0.977 and 0.081),AD AD 的血液学毒性比的血液学毒性比AP AP 重重(p(p 0.00000.0000）3-4 3-4 度疲劳度疲劳ADAD重重(p=0.03).(p=0.03).而神经病变在而神经病变在APAP组多见组多见(p=0.03)(p=0.03)。Cassier PA,et al.Breast Cancer Res Treat.2007 乳腺癌的化疗进展12A phase-III trial of doxorubicA phase-III trial of doxorubicin and docetaxel A phase-III trial of doxorubicin and docetaxel versus doxorubicin and paclitaxel in metastatic versus doxorubicin and paclitaxel in metastatic breast cancer:results of the ERASME 3 study.breast cancer:results of the ERASME 3 study.结论：AD与AP在生活质量和有效率无差别，但在副作用方面有差别。Cassier PA,et al.Breast Cancer Res Treat.2007 乳腺癌的化疗进展13A phase-III trial of doxorubicEvidence-based use of taxanes in the adjuvant setting of breast cancer.A Evidence-based use of taxanes in the adjuvant setting of breast cancer.A review of randomized phase III trials.review of randomized phase III trials.6个大型临床试验。验证 taxanes 在乳腺癌辅助治疗中的作用。各种不同的以anthracycline为主的方案作为对照组。有充分证据支持常规使用taxanes 治疗乳腺癌是有益的，包括激素受体阳性和Her-2阳性的病人。Estvez LG,et al.Cancer Treat Rev.2007Estvez LG,et al.Cancer Treat Rev.2007 乳腺癌的化疗进展14Evidence-based use of taxanes Combining chemotherapy and low-molecular-weight Combining chemotherapy and low-molecular-weight heparin for the treatment of advanced breast cancer:heparin for the treatment of advanced breast cancer:凝血激活在肿瘤进展中起作用，低分子肝素可影凝血激活在肿瘤进展中起作用，低分子肝素可影响肿瘤生长，显示响肿瘤生长，显示低分子肝素可影响化疗疗效低分子肝素可影响化疗疗效。Enoxaparin,0,5 or 1.0 mg/kg Enoxaparin,0,5 or 1.0 mg/kg，每天一次。，每天一次。Docetaxel 35-45 mg/m(2)Docetaxel 35-45 mg/m(2)，每周一次。，每周一次。PR:36%;SD:36PR:36%;SD:36Seeholzer N,et al.Blood Coagul Fibrinolysis.2007;18(5):415-423.Seeholzer N,et al.Blood Coagul Fibrinolysis.2007;18(5):415-423.乳腺癌的化疗进展15Combining chemotherapy and lowVinorelbine/docetaxel combination treatment of Vinorelbine/docetaxel combination treatment of metastatic breast cancer:a phase I studymetastatic breast cancer:a phase I study 方法:DOC:60 or 70 mg/m2,day 1 NVB:20 to 25 mg/m2 for i.v.on day 1,60 mg/m2 on day 8 or day 15 for oral,every 3 weeks.Bonneterre J,et al.Cancer Chemother Pharmacol.2007;60(3):365-373.Bonneterre J,et al.Cancer Chemother Pharmacol.2007;60(3):365-373.乳腺癌的化疗进展16Vinorelbine/docetaxel combinatA phase II clinical trial of ZD1839(Iressatrade mark)in A phase II clinical trial of ZD1839(Iressatrade mark)in combination with docetaxel as first-line treatment in patients with combination with docetaxel as first-line treatment in patients with advanced breast cancer.advanced breast cancer.gefitinib 250 mg，once daily docetaxel 75 mg/m(2)，every 3 weeks,until tumor progression,toxicity or other reasons for discontinuation.Dennison SK,et al.Invest New Drugs.2007Dennison SK,et al.Invest New Drugs.2007 乳腺癌的化疗进展17A phase II clinical trial of ZA phase II clinical trial of ZD1839(Iressatrade mark)in A phase II clinical trial of ZD1839(Iressatrade mark)in combination with docetaxel as first-line treatment in patients with combination with docetaxel as first-line treatment in patients with advanced breast cancer.advanced breast cancer.33例，中位治疗周期为5周期。临床受益率为51.5%。CR:1;PR:12;SD:4;ORR:39.4%。Dennison SK,et al.Invest New Drugs.2007Dennison SK,et al.Invest New Drugs.2007 乳腺癌的化疗进展18A phase II clinical trial of ZA phase II clinical trial of ZD1839(Iressatrade mark)in A phase II clinical trial of ZD1839(Iressatrade mark)in combination with docetaxel as first-line treatment in patients with combination with docetaxel as first-line treatment in patients with advanced breast cancer.advanced breast cancer.CONCLUSION:The combination of gefitinib and docetaxel is an active regimen in patients with previously untreated MBC.Dennison SK,et al.Invest New Drugs.2007Dennison SK,et al.Invest New Drugs.2007 乳腺癌的化疗进展19A phase II clinical trial of ZMulticenter phase II trial of neoadjuvant therapy with trastuzumab,Multicenter phase II trial of neoadjuvant therapy with trastuzumab,docetaxel,and carboplatin for human epidermal growth factor receptor-2-docetaxel,and carboplatin for human epidermal growth factor receptor-2-overexpressing stage II or III breast cancer:results of the GETN(A)-1 trial.overexpressing stage II or III breast cancer:results of the GETN(A)-1 trial.方法方法:HER-2-HER-2-阳性患者。阳性患者。trastuzumab 4 mg/kg(day 1),followed by trastuzumab 4 mg/kg(day 1),followed by 2 mg/kg weekly,2 mg/kg weekly,docetaxel 75 mg/m2 docetaxel 75 mg/m2，every 3 weeks,every 3 weeks,carboplatin(area under curve,6)for six cycles carboplatin(area under curve,6)for six cycles Coudert BP,et al.J Clin Oncol.2007;25(19):2678-2684.Coudert BP,et al.J Clin Oncol.2007;25(19):2678-2684.乳腺癌的化疗进展20Multicenter phase II trial of Multicenter phase II trial of neoadjuvant therapy with trastuzumab,Multicenter phase II trial of neoadjuvant therapy with trastuzumab,docetaxel,and carboplatin for human epidermal growth factor receptor-2-docetaxel,and carboplatin for human epidermal growth factor receptor-2-overexpressing stage II or III breast cancer:results of the GETN(A)-1 trial.overexpressing stage II or III breast cancer:results of the GETN(A)-1 trial.RESULTS:RESULTS:Sixty-seven patients,HER-2-positive,completed Sixty-seven patients,HER-2-positive,completed six cycles of therapy.six cycles of therapy.CR and PR:95%CR and PR:95%(85%and 10%).(85%and 10%).Grade 3/4 neutropenia and febrile neutropenia Grade 3/4 neutropenia and febrile neutropenia were 2%.were 2%.No symptomatic cardiac dysfunction occurred.No symptomatic cardiac dysfunction occurred.Coudert BP,et al.J Clin Oncol.2007;25(19):2678-2684.Coudert BP,et al.J Clin Oncol.2007;25(19):2678-2684.乳腺癌的化疗进展21Multicenter phase II trial of Multicenter phase II trial of neoadjuvant therapy with trastuzumab,Multicenter phase II trial of neoadjuvant therapy with trastuzumab,docetaxel,and carboplatin for human epidermal growth factor receptor-2-docetaxel,and carboplatin for human epidermal growth factor receptor-2-overexpressing stage II or III breast cancer:results of the GETN(A)-1 trial.overexpressing stage II or III breast cancer:results of the GETN(A)-1 trial.CONCLUSION:Trastuzumab plus docetaxel and carboplatin achieved a good pCR rate and favorable tolerability in stage II or III HER-2-positive breast cancer.Coudert BP,et al.J Clin Oncol.2007;25(19):2678-2684.Coudert BP,et al.J Clin Oncol.2007;25(19):2678-2684.乳腺癌的化疗进展22Multicenter phase II trial of Pathologic complete response with six compared with three cycles of Pathologic complete response with six compared with three cycles of neoadjuvant epirubicin plus docetaxel and granulocyte colony-neoadjuvant epirubicin plus docetaxel and granulocyte colony-stimulating factor in operable breast cancer:results of ABCSG-14.stimulating factor in operable breast cancer:results of ABCSG-14.epirubicin 75 mg/m2 docetaxel 75 mg/m2 on day 1 granulocyte colony-stimulating factor on days 3 through 10,ED+G every 21 days,three or six cycles.Steger GG,et al.J Clin Oncol.2007;25(15):2012-2018.Steger GG,et al.J Clin Oncol.2007;25(15):2012-2018.乳腺癌的化疗进展23Pathologic complete response wPathologic complete response with six compared with three cycles of Pathologic complete response with six compared with three cycles of neoadjuvant epirubicin plus docetaxel and granulocyte colony-neoadjuvant epirubicin plus docetaxel and granulocyte colony-stimulating factor in operable breast cancer:results of ABCSG-14.stimulating factor in operable breast cancer:results of ABCSG-14.Six cycles of ED+G,compared with three cycles,resulted in a significantly higher pCR rate(18.6%v 7.7%,P=.0045),a higher percentage of patients with negative axillary status(56.6%v 42.8%,P=.02).Rates of adverse events were similar,and no patients died on treatment.Steger GG,et al.J Clin Oncol.2007;25(15):2012-2018.Steger GG,et al.J Clin Oncol.2007;25(15):2012-2018.乳腺癌的化疗进展24Pathologic complete response wPhase II study of neoadjuvant docetaxel/vinorelbine followed by Phase II study of neoadjuvant docetaxel/vinorelbine followed by surgery and adjuvant doxorubicin/cyclophosphamide in women surgery and adjuvant doxorubicin/cyclophosphamide in women with stage II/III breast cancer.with stage II/III breast cancer.before surgery with 6 cycles of docetaxel 60 mg/m2 and vinorelbine 45 mg/m2,repeated every 2 weeks with granulocyte colony-stimulating factor and quinolone prophylaxis.Limentani SA,et al.Clin Breast Cancer.2006;6(6):511-517.Limentani SA,et al.Clin Breast Cancer.2006;6(6):511-517.乳腺癌的化疗进展25Phase II study of neoadjuvant Phase II study of neoadjuvant docetaxel/vinorelbine followed by Phase II study of neoadjuvant docetaxel/vinorelbine followed by surgery and adjuvant doxorubicin/cyclophosphamide in women surgery and adjuvant doxorubicin/cyclophosphamide in women with stage II/III breast cancer.with stage II/III breast cancer.RESULTS:59 patients,RR:98%,CR:63%.Grade 3/4 neutropenia(95%),neutropenic fever(22%),mucositis(5%),and pulmonary toxicity(5%).Limentani SA,et al.Clin Breast Cancer.2006;6(6):511-517.Limentani SA,et al.Clin Breast Cancer.2006;6(6):511-517.乳腺癌的化疗进展26Phase II study of neoadjuvant Dosage of capecitabine and cyclophosphamide combination Dosage of capecitabine and cyclophosphamide combination therapy in patients with metastatic breast cancertherapy in patients with metastatic breast cancer oral capecitabine 628 to 829 mg/m2 twice daily(bid)oral cyclophosphamide 33 to 50 mg/m2 bid,on days 1 to 14 a cycle every 21 days.Ohno S,et al.Anticancer Res.2007;27(2):1009-1013.Ohno S,et al.Anticancer Res.2007;27(2):1009-1013.乳腺癌的化疗进展27Dosage of capecitabine and cycDosage of capecitabine and cyclophosphamide combination Dosage of capecitabine and cyclophosphamide combination therapy in patients with metastatic breast cancertherapy in patients with metastatic breast cancer CONCLUSION:The capecitabine/cyclophosphamide combination regimen is well tolerated and active in MBC,and is being evaluated in a phase II study in anthracycline-pretreated MBC.Ohno S,et al.Anticancer Res.2007;27(2):1009-1013.Ohno S,et al.Anticancer Res.2007;27(2):1009-1013.乳腺癌的化疗进展28Dosage of capecitabine and cycPhase I/II trial of adjuvant dose-dense Phase I/II trial of adjuvant dose-dense docetaxel/epirubicin/cyclophosphamide(TEC)in stage docetaxel/epirubicin/cyclophosphamide(TEC)in stage II and III breast cancer.II and III breast cancer.docetaxel(T)75 mg/m(2),epirubicin(E)75 mg/m(2)(cohort 1,n=3)or 100 mg/m(2)(cohort 2,n=12),cyclophosphamide(C)500 mg/m(2)day 1,with pegfilgrastim 6 mg subcutaneously on day 2,every 2 weeks for six cycles.Burdette-Radoux S,et al.Breast J.2007;13(3):274-280.Burdette-Radoux S,et al.Breast J.2007;13(3):274-280.乳腺癌的化疗进展29Phase I/II trial of adjuvant dPhase I/II trial of adjuvant dose-dense Phase I/II trial of adjuvant dose-dense docetaxel/epirubicin/cyclophosphamide(TEC)in stage docetaxel/epirubicin/cyclophosphamide(TEC)in stage II and III breast cancer.II and III breast cancer.结论:剂量密度 TEC 化疗是可行的。与TAC等剂量时(docetaxel 75 mg/m(2),epirubicin 75 mg/m(2),cyclophosphamide 600 mg/m(2),毒性反应中等。Burdette-Radoux S,et al.Breast J.2007;13(3):274-280.Burdette-Radoux S,et al.Breast J.2007;13(3):274-280.乳腺癌的化疗进展30Phase I/II trial of adjuvant dGemcitabine Plus Doxorubicin as First-Line Treatment in Gemcitabine Plus Doxorubicin as First-Line Treatment in Advanced or Metastatic Breast Cancer(MBC),A Phase II Study.Advanced or Metastatic Breast Cancer(MBC),A Phase II Study.gemcitabine 1250mg/m2 IV on days 1,8 doxorubicin 60mg/m2 IV on day 1 every 21 days,for 6 cycles.El Serafi MM,et al.J Egypt Natl Canc Inst.2006;18(3):209-215.El Serafi MM,et al.J Egypt Natl Canc Inst.2006;18(3):209-215.乳腺癌的化疗进展31Gemcitabine Plus Doxorubicin aGemcitabine Plus Doxorubicin as First-Line Treatment in Gemcitabine Plus Doxorubicin as First-Line Treatment in Advanced or Metastatic Breast Cancer(MBC),A Phase II Study.Advanced or Metastatic Breast Cancer(MBC),A Phase II Study.RESULTS:RESULTS:CR:17.1%CR:17.1%PR40%PR40%SD:22.9%SD:22.9%ORR:57.1%.ORR:57.1%.MTTP:7 months MTTP:7 months The overall survival at 1 and 2 years was 74.2%The overall survival at 1 and 2 years was 74.2%and 34.2%;and 34.2%;El Serafi MM,et al.J Egypt Natl Canc Inst.2006;18(3):209-215.El Serafi MM,et al.J Egypt Natl Canc Inst.2006;18(3):209-215.乳腺癌的化疗进展32Gemcitabine Plus Doxorubicin aGemcitabine in the management of metastatic Gemcitabine in the management of metastatic breast cancer:a systematic review.breast cancer:a systematic review.共共共共8383个试验个试验个试验个试验，包括，包括，包括，包括4 4个个个个III III 期随机临床试验，全部期随机临床试验，全部期随机临床试验，全部期随机临床试验，全部III III 期临床期临床期临床期临床试验均为一线用药。试验均为一线用药。试验均为一线用药。试验均为一线用药。结果：其中结果：其中结果：其中结果：其中2 2个个个个IIIIII期试验证明含期试验证明含期试验证明含期试验证明含gemcitabinegemcitabine方案治疗方案治疗方案治疗方案治疗MBCMBC疗效高，副作用小。而另外疗效高，副作用小。而另外疗效高，副作用小。而另外疗效高，副作用小。而另外2 2个个个个IIIIII期试验却期试验却期试验却期试验却 认为没有认为没有认为没有认为没有临床受益，而副作用大。临床受益，而副作用大。临床受益，而副作用大。临床受益，而副作用大。结论结论结论结论:Gemcitabine Gemcitabine taxanetaxane一线或二线治疗一线或二线治疗一线或二线治疗一线或二线治疗MBCMBC疗疗疗疗效显著。效显著。效显著。效显著。Dent S,et al.Breast Cancer Res Treat.2007Dent S,et al.Breast Cancer Res Treat.2007 乳腺癌的化疗进展33Gemcitabine in the management Low dose Gemcitabine plus cisplatin in a weekly-based regimen Low dose Gemcitabine plus cisplatin in a weekly-based regimen as salvage therapy for relapsed breast cancer after taxane-as salvage therapy for relapsed breast cancer after taxane-anthracycline-containing regimens.anthracycline-containing regimens.gemcitabinegemcitabine(G)(initial dose 750 mg/m(2),or (G)(initial dose 750 mg/m(2),or 600 mg/m(2)if the patient had received more 600 mg/m(2)if the patient had received more than two previous CT lines)plus than two previous CT lines)plus cisplatincisplatin(P)(P)(initial dose 30 mg/m(2),or 20 mg/m(2)in(initial dose 30 mg/m(2),or 20 mg/m(2)in case of/=3 prior CT lines)on days 1 and 8 of a case of/=3 prior CT lines)on days 1 and 8 of a 21-day cycle.Treatment was postponed to day 21-day cycle.Treatment was postponed to day 15 if it could not be given on day 8,without dose 15 if it could not be given on day 8,without dose reduction.If treatment could not be given on day reduction.If treatment could not be given on day 15,a 20%dose reduction was allowed and 15,a 20%dose reduction was allowed and treatment given the next week.treatment given the next week.Snchez-Escribano Morcuende R,et al.Clin Transl Oncol.2007;9(7):459-464.Snchez-Escribano Morcuende R,et al.Clin Transl Oncol.2007;9(7):459-464.乳腺癌的化疗进展34Low dose Gemcitabine plus cispLow dose Gemcitabine plus cisplatin in a weekly-based regimen Low dose Gemcitabine plus cisplatin in a weekly-based regimen as salvage therapy for relapsed breast cancer after taxane-as salvage therapy for relapsed breast cancer after taxane-anthracycline-containing regimens.anthracycline-containing regimens.All had prior anthracyclines and taxanes.Other agents used included 5-FU/eniluracil,MTX,RPR 109881A,trastuzumab,cisplatin,VP16,vinorelbine,capecitabine and irinotecan.72.7%had received radiotherapy 68.1%hormonal therapy.Snchez-Escribano Morcuende R,et al.Clin Transl Oncol.2007;9(7):459-464.Snchez-Escribano Morcuende R,et al.Clin Transl Oncol.2007;9(7):459-464.乳腺癌的化疗进展35Low dose Gemcitabine plus cispLow dose Gemcitabine plus cisplatin in a weekly-based regimen Low dose Gemcitabine plus cisplatin in a weekly-based regimen as salvage therapy for relapsed breast cancer after taxane-as salvage therapy for relapsed breast cancer after taxane-anthracycline-containing regimens.anthracycline-containing regimens.Results:PR:9.1%,SD:36.4%.Clinical Benefit Rate(PR+SD):45.5%MTTP:4 months Median survival:8 months Toxicities grade 3 were neutropenia 35%and thrombocytopenia 15%.Snchez-Escribano Morcuende R,et al.Clin Transl Oncol.2007;9(7):459-464.Snchez-Escribano Morcuende R,et al.Clin Transl Oncol.2007;9(7):459-464.乳腺癌的化疗进展36Low dose Gemcitabine plus cispLow dose Gemcitabine plus cisplatin in a weekly-based regimen Low dose Gemcitabine plus cisplatin in a weekly-based regimen as salvage therapy for relapsed breast cancer after taxane-as salvage therapy for relapsed breast cancer after taxane-anthracycline-containing regimens.anthracycline-containing regimens.结论:曾进行过多次化疗的，PS较好的MBC.每周一次的 cisplatin-gemcitabine 是安全有效的挽救治疗方案。Snchez-Escribano Morcuende R,et al.Clin Transl Oncol.2007;9(7):459-464.Snchez-Escribano Morcuende R,et al.Clin Transl Oncol.2007;9(7):459-464.乳腺癌的化疗进展37Low dose Gemcitabine plus cispDose-finding study of capecitabine in combination with weekly paclitaxel Dose-