tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2016-4-49-57tumors-272Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL REPORTSОЦЕНКА ЭФФЕКТИВНОСТИ И ТОКСИЧНОСТИ ИНТЕНСИФИЦИРОВАННОГО ПЛАТИНОСОДЕРЖАЩЕГО РЕЖИМА ПРЕДОПЕРАЦИОННОЙ ХИМИОТЕРАПИИ ПРИ ПЕРВИЧНО ОПЕРАБЕЛЬНОМ РАКЕ МОЛОЧНОЙ ЖЕЛЕЗЫ С ТРОЙНЫМ НЕГАТИВНЫМ ФЕНОТИПОМEVALUATION OF EFFICACY AND TOXICITY OF NEOADJUVANT CHEMOTHERAPY WITH DOSE-DENSE DOXORUBICIN, CISPLATIN, AND PACLITAXEL IN PATIENTS WITH EARLY TRIPLE-NEGATIVE BREAST CANCERИгнатоваЕ. О.IgnatovaE. O.

Игнатова Екатерина Олеговна – кандидат медицинских наук, научный сотрудник, отделение клинической фармакологии и химиотерапии,  Москва 

Ignatova Ekaterina Olegovna – MD, PhD, research associate, Department of clinical pharmacology and chemotherapy

md.ignatova@gmail.comФроловаМ. А.FrolovaM. A.

Фролова Мона Александровна – кандидат медицинских наук, старший научный сотрудник, отделение клинической фармакологии и химиотерапии, Москва

Frolova Mona Aleksandrovna – MD, PhD, senior research associate, Department of clinical pharmacology and chemotherapy

drfrolova@yandex.ruПетровскийА. В.PetrovskyA. B.

Петровский Александр Валерьевич – кандидат медицинских наук, старший научный сотрудник, отделение радиохирургии, Москва

Petrovsky Alexander Valerievich – MD, PhD, senior research associate, Department of radiosurgery

alexpetrovsky@hotmail.comСтенинаМ. Б.SteninaM. B.

Стенина Марина Борисовна – доктор медицинских наук, ведущий научный сотрудник, отделение клинической фармакологии и химиотерапии, Москва

mstenina@mail.ruГлазковаЕ. В.GlazkovaE. V.

Глазкова Елена Владимировна – ординатор, отделение клинической фармакологии и химиотерапии НИИ клинической онкологии, Москва

Glazkova Elena Vladimirovna – PhD-student, Department of clinical pharmacology and chemotherapy

mdglazkova@gmail.comКрохинаО. В.KrokhinaO. V.

Крохина Ольга Владимировна – старший научный сотрудник, отделение реконструктивной и сосудистой онкохирургии, Москва

Krokhina Olga Vladimirovna – PhD, senior research associate, Department of reconstructive and vascular oncosurgery

kroha-os@mail.ruТюляндинС. А.TjulandinC. A.

Тюляндин Сергей Алексеевич – доктор медицинских наук, профессор, заведующий отделением клинической фармакологии и химиотерапии, Москва

Tjulandin Sergei Alekseyevich – MD, PhD, DSc, Professor, head of department,  Department of clinical pharmacology and chemotherapy

stjulandin@mail.ruНаучно – исследовательский институт онкологии, Российский онкологический научный центр имени Н.Н. БлохинаРоссияN.N.Blokhin Russian Cancer Research Center, MoscowRussian Federation201616112016044957Copyright © Игнатова Е.О., Фролова М.А., Петровский А.В., Стенина М.Б., Глазкова Е.В., Крохина О.В., Тюляндин С.А., 20162016Игнатова Е.О., Фролова М.А., Петровский А.В., Стенина М.Б., Глазкова Е.В., Крохина О.В., Тюляндин С.А.Ignatova E.O., Frolova M.A., Petrovsky A.B., Stenina M.B., Glazkova E.V., Krokhina O.V., Tjulandin C.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/272

Тройной негативный рак молочной железы (РМЖ) характеризуется агрессивностью течения, высокой чувствительностью к химиотерапии, ранним рецидивированием, а также отсутствием известных мишеней для таргетной терапии. Ввиду недостаточной эффективности стандартных подходов в лекарственном лечении РМЖ с тройным негативным фенотипом представляется чрезвычайно актуальным поиск интенсивных режимов неоадъювантной химиотерапии. Целью исследования являлась оценка эффективности и токсичности комбинации цисплатина, доксорубицина, паклитаксела у больных ранним РМЖ с тройным негативным фенотипом в предоперационном режиме. В исследование включены 41 больных ранним РМЖ с тройным негативным фенотипом (T1–2 N0–1M0). Больные получали лечение по схеме: цисплатин 30 мг/м2 в/в кап., доксорубицин 25 мг/м2 в/в кап., паклитаксел 100 мг/м2 в/в кап. Еженедельно 8 введений с поддержкой ГКСФ в дозе 5 мкг/кг со 2 по 4 день. Частота развития объективных эффектов во всей группе составила 38/40 (95,0%): полных регрессий – 12/40 (30,0%), частичных регрессий – 26/40 (65,0%), стабилизаций – 2/40 (5,0%). Из 40 прооперированных больных у 26/40 (65,0%) достигнута полная патоморфологическая регрессия. 2-летняя безрецидивная выживаемость – 89,4%. 2-летняя общая выживаемость – 95,1%. Несмотря на относительно высокую токсичность комбинации цисплатина, доксорубицина, паклитаксела, доказана ее высокая эффективность у больных ранним РМЖ с тройным негативным фенотипом.

Triple-negative breast cancer (TNBC) is characterized by an aggressive behavior, highly sensitivity to chemotherapy, early recurrence, and also the absence of known targets for targeted therapies. TNBC is extremely impotant search for intensive regimens of neoadjuvant chemotherapy, because of insufficient effectiveness of conventional therapies. The aim of the study was to evaluate the efficacy and toxicity of cisplatin, doxorubicin, paclitaxel in patients with early breast cancer with triple-negative phenotype in preoperative mode. The study included 41 patients with early breast cancer, triple negative phenotype (T1–2 N0–1M0). Patients were treated with cisplatin 30 mg/m2 / IV., Doxorubicin 25 mg/m2 / IV., Paclitaxel  100 mg/m2 / IV. weekly for planned 8 weeks  with G-CSF 300 mcg 2–4 days followed by surgery. The rate of objective response was 38/40 (95%) complete response – 12/40 (30%), partial regression – 26/40 (65%), stabilization – 2/40 (50%). 40 hftients were treated with surgery, 26/40 (65%) achieved a complete pathological regression. 2-year disease-free survival – 89.4%. 2-year overall survival – 95.1%. Combination of cisplatin, doxorubicin, paclitaxel, it proved its high efficacy in patients with early breast cancer with triple-negative phenotype, despite it’ high toxicity. 

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The authors declare that there are no conflicts of interest present.