Hiệu quả điều trị nội tiết kết hợp thuốc ức chế CDK4/6 trên bệnh nhân ung thư vú tái phát di căn thụ thể nội tiết dương tính, HER2 âm tính
Authors: Lê Đức 
Published: May 2023

TÓM TẮT

Mục tiêu: Mô tả đặc điểm lâm sàng, cận lâm sàng cũng như đánh giá hiệu quả của điều trị nội tiết kết hợp thuốc ức chế CDK4/6 trên bệnh nhân ung thư vú tái phát di căn thụ thể nội tiết dương tính, HER2 âm tính.

Đối tượng, phương pháp: Nghiên cứu mô tả hồi cứu kết hợp tiến cứu trên 61 bệnh nhân được chẩn đoán ung thư biểu mô tuyến vú tái phát di căn thụ thể nội tiết dương tính, HER2 âm tính tại Bệnh viện K từ tháng 01/2020 tới tháng 10/2022.

Kết quả: Tuổi trung bình ở thời điểm tái phát, di căn là 54,0 tuổi. Đa số bệnh nhân tái phát sau 2 năm điều trị triệt căn chiếm 75%. Các vị trí di căn thường gặp lần lượt là xương, phổi và gan chiếm tỷ lệ 70,5%, 36,0% và 24,6%. Tỷ lệ đáp ứng chung của phác đồ là 45,9%; trong đó 1,6% đáp ứng hoàn toàn, đáp ứng một phần là 44,3%, bệnh giữ nguyên là 31,1%. Tỷ lệ đáp ứng ở nhóm điều trị phác đồ bước 1 và bước sau lần lượt là 58,8% và 29,6%, sự khác biệt có ý nghĩa thống kê với p = 0,023. Trung vị thời gian sống thêm bệnh không tiến triển là 17 tháng.

Kết luận: Điều trị nội tiết kết hợp thuốc ức chế CDK4/6 trên nhóm bệnh nhân ung thư vú tái phát di căn thụ thể nội tiết dương tính, HER2 âm tính cho tỉ lệ đáp ứng, thời gian sống thêm bệnh không tiến triển cao do vậy phác đồ có thể được sử dụng rộng rãi hơn trong thực hành lâm sàng.

ABSTRACT THE EFFICACY OF ENDOCRINE COMBINED WITH CDK4/6 INHIBITORS IN PATIENTS WITH HORMONE RECEPTOR - POSITIVE, HER2 - NEGATIVE RECURENT OR METASTATIC BREAST CANCER

Objectives: To evaluate the efficacy of endocrine combined with CDK4/6 inhibitors in patients with hormone receptor - positive, HER2 - negative recurrent or metastatatic breast cancer.

Methods: A retrospective and prospective descriptive study on 61 patients diagnosed with hormone receptor - positive, HER2 - negative metastatic or recurrent breast cancer at K Hospital from January 2020 to October 2022.

Result: The mean age was 54.0 years. The majority of patients relapsed after 2 years of radical treatment, accounting for 75%. The most common metastatic sites

were bone, lung and liver, respectively, accounting for 70.5%, 36.0% and 24.6%. The overall response rate of the regimen was 45.9%. The complete response rate was 1.6%, the partial response rate was 44.3%, 31.1% of the patients were stable. The overall response rate in first - line therapy was better than that in the second - line of treatment (ORR: 67,5% vs 37,5%; p = 0,039). The response rate in the first line and subsequent lines were 58.8% and 29.6%, respectively, the difference was statistically significant with p = 0.023. Median progression - free survival was 17 months.

Conclusion: Endocrine combined with CDK4/6 inhibitors is effective in high response rates and progression - free survival for patients with recurrent or metastatic of hormone receptor - positive, HER2 - negative breast cancer. This regimens may be more widely used in clinical practice.