Nearly 5O years, breast cancer, a serious threat to people’s health. Almost all populations of breast cancer incidence rates are on the rise, with an average annual increase of about l%. Estimated global annual incidence of patients with more than 1 million. While the treatment of breast cancer has made great progress, but there are still 25% of patients die of the disease. The main treatment for breast cancer are surgery, radiotherapy, chemotherapy and endocrine therapy with traditional Chinese medicine, this article is used chemotherapy drugs in recent years, new progress summarized as follows:
1 taxane
20th Century yew 90 years the advent of drugs known as a major breakthrough in cancer chemotherapy, represented by drug paclitaxel (Taxol, paclitaxe1) and docetaxel (Taxotere, taxotere), and its mechanism is the same, both for anti-M-phase microtubule-cycle specific drugs, the promotion of microtubule polymerization to form a stable microtubules, thus impeding with the mitosis and other important cell functions related to micro-restructuring, so effective against a variety of tumors. Studies have shown that paclitaxel anti-tumor therapy in breast cancer have shown better efficacy, especially in the past have been off chemotherapy for the treatment of relapsed patients also achieved good results.
2 fluorouracil drugs
Capecitabine (Xeloda, capecitabine, xeloda) is a new fluorouracil drugs, after oral absorption in the intestine. Through the three enzymatic reaction be quickly converted into a 5-fluorouracil, has anti-tumor effect. Mechanism is due to capecitabine final step enzymatic reactions are needed thymidine phosphorylase (TP) in tumor tissues were significantly higher than normal tissue, so that capecitabine in tumor tissues into 5 1 priority Fu, This determines that capecitabine was highly selective for the tumor. Many studies have shown that capecitabine is not only anthracyclines and paclitaxel in patients resistant to drugs have a higher activity of the 5-Fu-resistant patients also have good effect.
As a convenient, effective and well tolerated treatment of breast cancer. Capecitabine alone has obvious therapeutic effect of breast cancer. In order to improve breast cancer chemotherapy, the scientists further observed capecitabine with other cytotoxic drugs, in particular, can lead to tumor TP activity increases the efficacy of the drug combination. Because capecitabine to be absorbed in the liver and tumor tissue is generated by the TP catalytic Fu can play five one anti-tumor effect. Study found that drugs such as taxol TP activity in tumor cells can increase, will help to further improve Capecitabine anti-tumor activity, which for capecitabine in combination with these drugs in order to achieve a better effect was provided.
2.1 Capecitabine in combination with paclitaxel drugs:
For metastatic breast cancer, capecitabine and paclitaxel are the exact efficacy of drugs. Because Taxol-type drugs can increase TP activity in tumor tissue, and capecitabine have synergistic effect. Capecitabine major adverse reactions were hand-foot syndrome, paclitaxel major adverse reactions were myalgia, paresthesia, alopecia, less overlap between the two main side effects, which makes a joint application security is guaranteed.
A multi-center, international cooperation, Phase â…¢ clinical trials comparing capecitabine with paclitaxel drugs Taxotere (docetaxel, taxotere) combined application and efficacy of Taxotere alone. The 511 cases of anthracycline antitumor drugs ineffective in patients with advanced breast cancer were randomly divided into two groups, respectively, combined with capecitabine and docetaxel (capecitabine 1250 mg / m, oral, 2 times / d , the first 1-14 days of taking the medication; docetaxel 75 mg/m2. 1st day medication) or docetaxel alone (100 mg / m). 21 d is a cycle, much better than the former group after the effective group, two groups the effective rates were 42% and 30%, with a median time to progression were 6.1 months and 4.2 months. The median survival time of 14.5 months and 11.5 months. The combination group in order to gastrointestinal side effects, adverse reactions, mainly hand-foot syndrome; and fever, myalgia, arthralgia, neutrophil neutropenia in a separate drug group in the more common. The use of appropriate drugs, dosage adjustments can control the adverse reactions. â…¢ grade adverse reactions more common in the combination group. Is divided into two groups of 71% and 49%, however, grade â…£ adverse events more common in the docetaxel group (31% and 25%).
2.2 Capecitabine with the combination of anthracycline antitumor drugs:
Phase II clinical study looked at capecitabine, docetaxel, epirubicin three drugs combined with (TEX program) as first-line drug treatment of locally metastatic breast cancer treatment. This regimen is more secure, â…¢ grade lower incidence of adverse reactions. Grade â…£ rare adverse reactions, the most common grade â…£ â…¢ an adverse reaction of febrile neutropenia neutropenia, the incidence is only 16%.
Information can be seen from the above: effect of chemotherapy sure, but the greater toxicity. Therefore, breast cancer treatment methods should not be a single, integrated Chinese and Western medicine should be used combination therapy will be effective in medicine and surgery, radiotherapy and chemotherapy, endocrine therapy, immunotherapy combined to improve the postoperative physical and mobilize the body resistance to diseases, reduce the release Chemotherapy side effects, improve quality of life, control of tumor recurrence and metastasis and improve patient quality of life and prolong survival has an important role and unique advantage.
