tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2017-7-4-29-40tumors-436Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL REPORTSЭФФЕКТИВНОСТЬ И ТОКСИЧНОСТЬ АЛЬТЕРНИРУЮЩЕГО МНОГОКОМПОНЕНТНОГО РЕЖИМА НЕОАДЪЮВАНТНОЙ ХИМИОТЕРАПИИ МЕСТНОРАСПРОСТРАНЕННОГО РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ С ТРОЙНЫМ НЕГАТИВНЫМ ФЕНОТИПОМEVALUATION OF EFFICACY AND TOXICITY OF NEOADJUVANT ALTERNATING CHEMOTHERAPY IN PATIENTS WITH LOCALLY ADVANCED TRIPLE NEGATIVE BREAST CANCERИгнатоваЕ. О.IgnatovaE. O.

Екатерина О. Игнатова - кандидат медицинских наук научный сотрудник, отделение клинической фармакологии и химиотерапии НИИ клинической онкологии.

Ekaterina O. Ignatova - MD, PhD, Research Associate, Department of Clinical Pharmacology and Chemotherapy.

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

Мона А. Фролова - кандидат медицинских наук, старший научный сотрудник, отделение клинической фармакологии и химиотерапии НИИ клинической онкологии.

Mona A. Frolova - MD, PhD, Senior Research Associate, Department of Clinical Pharmacology and Chemotherapy.

drfrolova@yandex.ruСтенинаМ. Б.SteninaM. B.

Марина Б. Стенина - доктор медицинских наук, ведущий научный сотрудник, отделение клинической фармакологии и химиотерапии НИИ клинической онкологии.

Marina B. Stenina - MD, DSc Med, Leading Research Associate, Department of Clinical Pharmacology and Chemotherapy.

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

Елена В. Глазкова - аспирант, отделение клинической фармакологии и химиотерапии НИИ клинической онкологии.

Elena V. Glazkova - PhD-student, MD, Department of Clinical Pharmacology and Chemotherapy.

mdglazkova@gmail.comПетровскийА. В.KrokhinaO. V.

Александр В. Петровский - кандидат медицинских наук, заместитель директора НИИ КиЭР.

Olga V. Krokhina - MD, Senior Research Associate, Department of Reconstructive and Vascular Oncosurgery.

alexpetrovsky@hotmail.comКрохинаО. В.PetrovskyA. B.

Ольга В. Крохина - старший научный сотрудник, отделение реконструктивной и сосудистой онкохирургии НИИ клинической онкологии.

Alexander V. Petrovsky - MD, PhD, Deputy Director, Research Institute of Clinical and Experimental Radiology.

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

Сергей А. Тюляндин - доктор медицинских наук, профессор, заведующий отделением клинической фармакологии и химиотерапии НИИ клинической онкологии.

Sergei A. Tjulandin - MD, DSc Med, Professor, Head of the Department of Clinical Pharmacology and Chemotherapy.

stjulandin@mail.ruФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияN. N. Blokhin Russian Cancer Research CenterRussian Federation201718012018742940Copyright © Игнатова Е.О., Фролова М.А., Стенина М.Б., Глазкова Е.В., Петровский А.В., Крохина О.В., Тюляндин С.А., 20182018Игнатова Е.О., Фролова М.А., Стенина М.Б., Глазкова Е.В., Петровский А.В., Крохина О.В., Тюляндин С.А.Ignatova E.O., Frolova M.A., Stenina M.B., Glazkova E.V., Krokhina O.V., Petrovsky A.B., Tjulandin C.А.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/436

Одним из путей улучшения результатов лечения больных местнораспространенным раком молочной железы с тройным негативным фенотипом (ТНРМЖ) является поиск максимально эффективных режимов неоадъювантной химиотерапии (ХТ), так как известно, что при достижении полной патоморфологической регрессии (пПР) прогноз заболевания существенно улучшается, приближаясь к прогнозу наиболее благоприятных подтипов. Целью исследования была оценка эффективности и токсичности неоадъювантного режима «карбоплатин AUC2 в/в капельно, паклитаксел 60 мг/м2 в/в капельно еженедельно 9 введений, далее доксорубицин 25 мг/м2 в/в капельно еженедельно 9 введений, циклофосфан 50 мг внутрь ежедневно и капецитабин 1500 мг внутрь ежедневно 9 недель» у больных местнораспространенным ТНРМЖ. В исследование были включены 45 больных с IIIA, IIIB, IIIC стадиями ТНРМЖ. Частота объективных эффектов во всей группе составила 40/45 (88,9%), из них полных регрессий – 7/45 (15,6%), частичных регрессий – 33/45 (73,3%). Из 45 больных, включенных в исследование, 44 были оперированы. У 27 из 44 (61,4%) оперированных больных достигнута пПР. 3-летняя безрецидивная выживаемость составила 71%, а 3-летняя общая выживаемость – 81%. Основными видами токсичности были нейтропения 3–4 ст. (40%), стоматит 1–3 ст. (55%), ладонно-подошвенный синдром 1–3 ст. (65%). Несмотря на относительно высокую токсичность лечения, изученный альтернирующий многокомпонентный режим обладал высокой эффективностью и позволил более чем у половины больных (61,4%) достичь пПР.

One way to improve the results of treatment of patients with locally advanced triple-negative breast cancer (TNBC) is to find the most effective neoadjuvant chemotherapy regimen. It has been shown that patients (pts) with TNBC with pathological complete regression (pCR) after neoadjuvant chemotherapy have better survival. The aim of the study was to evaluate the efficacy and toxicity of induction chemotherapy regimen, including 2 consequent chemotherapy regimens: рaclitaxel 60 mg/m2  IV weekly plus сarboplatinum AUC2 IV weekly for 9 weeks, then doxorubicin 25 mg/m2 IV weekly plus cyclophosphamide 50 mg per os q. i. d. plus capecitabine 500 mg t. i. d for 9 weeks. The study included 45 patients with TNBC, stages IIIA, IIIB, IIIC. Overall response rate was 40/45 (88,9%) with 7/45 (15,6%) of complete responses and 33/45 (73,3%) of partial responses. Forty-four patients underwent surgery. Twenty seven patients (61,4%) achieved pCR. Three-year disease-free survival was 71% and overall survival was 81%. The most common types of toxicity were neutropenia (40% grade 3–4), mucositis (55% grade 1–3) and hand-foot syndrome (65% grade 1–3). Despite relatively high toxicity this alternating multicomponent induction chemotherapy regimen had high efficacy. More than half of patients (61.4%) achieved pCR.

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