The life-expectancy of women with metastatic breast cancer (MBC) is closely linked to response to therapy. A significant increase in progression-free survival (PFS) and overall survival (OS) has been demonstrated in women who achieve a complete response. Anthracycline combinations have been proven as highly effective in MBC, and anthracycline regimens plus cyclophosphamide with or without fluorouracil were established as first-line chemotherapy for MBC in the 1990s. Clinical trials have shown that anthracycline-taxane combinations are more effective than anthracyclines or taxanes alone in terms of overall response rates (ORR), PFS and OS in women who have not received prior anthracycline chemotherapy. The use of anthracycline-based regimens is limited, however, by the widespread use of anthracycline adjuvant therapy and the development of anthracycline-resistance. Platinum-taxane combinations have similar efficacy to anthracycline-based regimens and are well-tolerated by patients. Carboplatin combined with paclitaxel or docetaxel is more effective than carboplatin or taxanes alone, with ORR of 53-62%. Taxane combinations with gemcitabine or capecitabine are also more effective than docetaxel, paclitaxel, capecitabine or gemcitabine administered alone. The efficacy of docetaxel and paclitaxel can be increased, and drug-related toxicity decreased, by adapting dose-dense schedules of drug administration. The addition of trastuzumab to taxane-based chemotherapy increases the efficacy of taxane-based regimens in women with HER2-positive MBC.

中文翻译：

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如何最大化紫杉烷类药物在乳腺癌中的功效。

转移性乳腺癌（MBC）妇女的预期寿命与对治疗的反应密切相关。在获得完全缓解的女性中，无进展生存期（PFS）和总生存期（OS）显着增加。蒽环类药物组合已被证明在MBC中非常有效，1990年代，蒽环类药物加环磷酰胺加或不加氟尿嘧啶已被确立为MBC的一线化疗药物。临床试验表明，在未接受过蒽环类化学疗法的女性中，蒽环类-紫杉烷类联合用药比单独使用蒽环类或紫杉类类更有效。基于蒽环类药物的治疗方案受到限制，但是，蒽环类辅助疗法的广泛使用和耐药性的发展。铂-紫杉烷类药物的组合与基于蒽环类的疗法具有相似的疗效，并且被患者很好地耐受。卡铂联合紫杉醇或紫杉萜比单独使用卡铂或紫杉烷类更有效，ORR为53-62％。紫杉烷与吉西他滨或卡培他滨的组合也比单独给药的多西他赛，紫杉醇，卡培他滨或吉西他滨更有效。通过调整药物的剂量密集时间表，可以提高多西紫杉醇和紫杉醇的疗效，并降低与药物相关的毒性。将曲妥珠单抗添加到基于紫杉烷的化疗中可提高基于HER2阳性MBC的女性中基于紫杉烷的治疗方案的疗效。铂-紫杉烷类药物的组合与基于蒽环类的疗法具有相似的疗效，并且被患者很好地耐受。卡铂联合紫杉醇或紫杉萜比单独使用卡铂或紫杉烷类更有效，ORR为53-62％。紫杉烷与吉西他滨或卡培他滨的组合也比单独给药的多西他赛，紫杉醇，卡培他滨或吉西他滨更有效。通过调整药物的剂量密集时间表，可以提高多西紫杉醇和紫杉醇的疗效，并降低与药物相关的毒性。将曲妥珠单抗添加到基于紫杉烷的化疗中可提高基于HER2阳性MBC的女性中基于紫杉烷的治疗方案的疗效。铂-紫杉烷类药物的组合与基于蒽环类的疗法具有相似的疗效，并且被患者很好地耐受。卡铂联合紫杉醇或紫杉萜比单独使用卡铂或紫杉烷类更有效，ORR为53-62％。紫杉烷与吉西他滨或卡培他滨的组合也比单独给药的多西他赛，紫杉醇，卡培他滨或吉西他滨更有效。通过调整药物的剂量密集时间表，可以提高多西紫杉醇和紫杉醇的疗效，并降低与药物相关的毒性。在基于taxane的化疗中加入曲妥珠单抗可提高HER2阳性MBC患者基于紫杉醇的治疗方案的疗效。ORR为53-62％。紫杉烷与吉西他滨或卡培他滨的组合也比单独给药的多西他赛，紫杉醇，卡培他滨或吉西他滨更有效。通过调整药物的剂量密集时间表，可以提高多西紫杉醇和紫杉醇的疗效，并降低与药物相关的毒性。将曲妥珠单抗添加到基于紫杉烷的化疗中可提高基于HER2阳性MBC的女性中基于紫杉烷的治疗方案的疗效。ORR为53-62％。紫杉烷与吉西他滨或卡培他滨的组合也比单独给药的多西他赛，紫杉醇，卡培他滨或吉西他滨更有效。通过调整药物的剂量密集时间表，可以提高多西紫杉醇和紫杉醇的疗效，并降低与药物相关的毒性。将曲妥珠单抗添加到基于紫杉烷的化疗中可提高基于HER2阳性MBC的女性中基于紫杉烷的治疗方案的疗效。