Observation on the efficacy of Everolimus combined with Exemestane in the treatment of postmenopausal ER-positive and HER-2-negative advanced breast cancer / 中国综合临床

ABSTRACT

Objective:To investigate the effect of Everolimus combined with Exemestane in the treatment of postmenopausal hormone receptor positive and human epidermal growth factor receptor-2(HER-2) negative nonsteroidal aromatase inhibitors(NSAIs) resistant patients with advanced breast cancer.Methods:From February 2015 to August 2017, 51 patients of advanced breast cancer in our hospital to retrospective prospective study analysis.They were randomly divided into combined group (25 cases) and Exemestane group (26 cases). The combination group was treated with Everolimus combined with Exemestane, and the Exemestane group was treated with exemestane.The short-term efficacy, progression-free survival (PFS) and adverse reactions were compared between the two groups.Results:There was no complete remission in both groups.There was no significant difference in objective remission rate between combined group (21.7%, 5/23) and exemestane group (15.4%, 4/26) ( P=0.570). There was significant difference in disease control rate between combined group (69.6%, 16/23) and exemestane group (38.5%, 10/26) ( P=0.030). The median PFS of the combined group was 6.6 months and that of the Exemestane group was 3.3 months.There was significant difference between the two groups (χ 2=5.369, P=0.02). In the combined group, 14 cases (56%, 14/25) had serious adverse reactions, and 2 of them had withdrawn from the study after discontinuation of Everolimus for more than 28 days.The incidence of stomatitis, fatigue and pneumonia were 60.0% (15/25), 48.0% (12/25) and 16.0% (4/25) in the combined group, and 11.5% (3/26), 11.5% (3/26) and 0 (0) in the Exemestane group respectively.There were significant differences between the two groups (P values were 0.010, 0.001 and 0.028, respectively). Conclusion:Everolimus combined with exemestane can improve the disease control rate and prolong the median PFS of patients with advanced breast cancer with hormone receptor-positive and HER 2-negative NSAIs resistance after menopause.It can be used as a treatment option for advanced breast cancer with hormone receptor-positive and HER 2-negative NSAIs resistance after menopause.At the same time, the safety assessment of Everolimus in clinical use needs close attention and further observation.