Outcome of Fulvestrant in Pretreated Metastatic Breast Cancer Patients in a Medical Center in Taiwan

Fulvestrant用於治療經多種療法仍轉移的乳癌－台灣患者之結果探討

10.6323/JoCRP.2011.27.1.2

鄭翠芬(Fiona Tsui-Fen Cheng)；陳遠光(Yang-Kong Chen)

法洛德注射劑 ； 經治療仍惡化乳癌 ； 轉移性乳癌 ； Fulvestrant ； pre-treated breast cancer ； metastatic breast cancer

台灣癌症醫學雜誌

27卷1期（2011 / 02 / 01）

10 - 18

英文

背景：Fulvestrant是一種有選擇性的雌激素接受體拮抗劑，目前臺灣衛生署通過的適應症為女性乳癌已接受輔助性抗雌激素療法但疾病仍復發，或使用抗雌激素療法但疾病仍惡化的雌激素受體為陽性的停經婦女，我們嘗試在台灣某醫學中心的患者上評估fulvestrant在此病人族群中的有效性及安全性。方法：從民國94年到民國98年，我們以每個月肌肉注射fulvestrant 250mg一次治療15位曾以雌激素療法及化學療法治療過，卻仍有疾病惡化的轉移性乳癌患者，並於此呈現我們的觀察。結果：在這15位患者開始以fulvestrant治療前，每一位都曾接受過aromatase inhibitors的治療，而當中有12位更曾接受過各種不同的化學治療。在接受了平均25.4個劑量的fulvestrant之後，有九位患者（60%）達到了穩定疾病的狀態，且維持了有平均2.7年之久（短為2年，長為5年）。另外六位患者（40%）在接受了平均10.8個劑量的fulvestrant後，疾病仍是惡化且當中有5位（33.3%）終究死亡。治療期間沒有患者因fulvestrant的副作用而需停藥，且發生的副作用多為輕微的反應。結論：Fulvestrant對轉移性乳癌，且接受過雌激素療法及化學療法但疾病仍惡化的患者，是有效且安全的，尤其它副作用少，故可為乳癌末期病人提供另一種治療選擇，並幫助他們維持較好的生活品質。

Background: Fulvestrant is a selective estrogen receptor antagonist, indicated for treating hormone receptor-positive metastatic breast cancer in postmenopausal women with disease progression following antiestrogen therapy. This is the first observational study in Taiwan to assess the efficacy and tolerability of fulvestrant in Taiwanese women.Methods: A total of 15 postmenopausal women with metastatic breast cancer, who were treated with endocrine and cytotoxic agents and still had progression of disease, were begun on fulvestrant (250 mg intramuscular injection monthly) from 2005 to 2009 in a medical center in Taiwan. We present the observations while treating these patients.Results: All patients had been previously treated with aromatase inhibitors (AI), while 12 of them also received chemotherapy before fulvestrant. Nine patients (60%) achieved stable disease after an average of 25.4 doses of fulvestrant, and the stable disease lasted for an average of 2.7 years (range, 2 to 5 years). Six patients (40%) experienced progression of disease after an average of 10.8 doses of fulvestrant, and 5 of them (33.3%) died. No patient discontinued fulvestrant treatment due to adverse events, and only minor reactions were reported.Conclusions: Fulvestrant was effective and well-tolerated in treating patients with metastatic breast cancer who had progression on endocrine therapy and/or chemotherapy. It offers another treatment option for patients with terminal disease, and may help them maintain a better quality of life.