The Clinical Study Of GP And NP Regimens In The Treatment Of Triple Negative Metastatic Breast Cancer Resistance To Anthracycline/Taxane

Breast Cancer is the most common malignant tumors in women currently, it is one of the more common malignant tumors that cause women killed. The incidence of breast cancer significantly increase in recent years, and seriously threatened the health of women. Breast Cancer is a highly heterogeneity malignant tumor, its particularities display in molecular level, tumor biological behavior, pathological morphology, immune phenotype and response to treatment, etc., and there are big differences in these respects. According to the immunohistochemical detection, breast cancer can be divided into five important clinical subtypes are as follows: Luminal A; Luminal B/HER-2 negative; Luminal B/HER-2 positive; HER-2(non-luminal); Triple negative. Triple negative breast cancer(TNBC) is a special subtype of breast cancer. TNBC has special molecular biologic characteristics, histologic and clinical features. Triple negative breast cancer has poor clinical prognosis than other types of breast cancer for it has no opportunities of endocrine therapy and HER-2 targeted treatment. Chemotherapy is the main effective treatment of Triple negative breast cancer currently, but triple negative breast cancer is easy to become resistant to multiple types of chemotherapy, fewer treatment options exist and it has higher rate of recurrence and distant metastasis. So the study of the treatment of triple negative breast cancer has important clinical significance.Objective: Through retrospective analysis 63 patients of Metastatic triple negative breast cancer from January 1. 2010 to January 1. 2013. All of these 63 patients were triple negative breast cancer resistance to Taxane/Anthracycline. 34 of cases treatment with gemcitabine plus cisplatin(GP) and 29 of cases treatment with vinorelbine plus cisplatin(NP). We through the contrast analysis two kinds of chemotherapy regimens’ differences of the resent curative efficacy, the curative efficacy, the safety, the toxic and adverse reactions. In order to provide the best regimen in the first-line treatment with triple negative breast cancer resistance to Taxane/Anthracycline.Patients and Methods: We collect 63 triple negative metastatic breast cancer patients in second affiliated hospital of Dalian medical university from January 1, 2010 to January 1, 2013. These 63 patients were divided into two groups. GP group 34 cases, Gemcitabine 1000mg/㎡, intravenous infusion, d1,d8;Cisplatin 75 mg/㎡,intravenous infusion,d1-3, 21 days of a cycle.NP group 29 cases, Vinorelbine 30 mg/㎡, intravenous infusion, d1, d8;Cisplatin 75 mg/㎡, intravenous infusion, d1-3, 21 days of a cycle. The efficacy and toxicities of the two groups were evaluated two cycles after treatment respectively. Statistical analysis by SPSS 17.0. Clinical datas described by percentage and median. Count datas between groups were compared using the 2? test. Survival condition using the Kaplan-Meier analysis, survival rates were compared using the log-rank test.Results: The total response rate(RR) in the GP was 23.5% and the NP group was 27.6%, the clinical benefit of treatment in the GP was 52.9% and the NP group was 55.2%, with statistical significance respectively(P>0.05). The median progression free survival(FPS) time was 10 months(95% CI:3.1—16.9) and the median overall survival(OS) time was 16 months(95% CI:7.7—24.3)in the GP; The median progression free survival(FPS) time was 16 months(95% CI:3.7—28.3) and 1 the median overall survival(OS) time was 8 months(95% CI:9.5—26.5) in the NP group, with statistical significance respectively(P>0.05).The main toxic and adverse reactions in the two group were myelo suppression, gastrointestinal reaction, hepar and renal functional lesion and alopecia.Conclusion: Through comparative studies GP and NP regimens in the treatment of triple negative breast cancer resistance to Taxane/Anthracycline, it is showed that the curative effects of two regimens were similar, the toxic and adverse reactions of two regimens chemotherapy was closed. So GP and NP regimens could be used as first-line therapy in the treatment of triple negative breast cancer resistance to Taxane/Anthracycline.