关键词: 拉帕替尼, 曲妥珠单抗, 人表皮生长因子受体2, 乳腺癌, 生存

Abstract: Objective To explore the efficacy of lapatinib combined with trastuzumab in the treatment of patients with human epidermal growth factor receptor-2 (HER2)-positive breast cancer and its effects on survival prognosis.Methods 86 patients with HER2-positive breast cancer who were treated with neoadjuvant chemotherapy from April 2016 to June 2018 were selected as the research subjects,and they were divided into observation group (lapatinib combined with trastuzumab treatment) and control group (trastuzumab treatment) by means of the random number table method,with 43 cases in each group.The therapeutic efficacy of the two groups was compared,and the changes in levels of vascular endothelial growth factor,inflammatory factors and apoptotic factors were recorded before and after treatment.All patients were followed up for 3 years or until their death,and the cumulative survival rate was compared between the two groups,and the occurrence of adverse events during treatment were counted.Results There were no significant differences in objective response rate (ORR) and disease control rate (DCR) between observation group and control group (72.09% vs 58.14%,86.07% vs 74.42%,P>0.05).After treatment,the levels of vascular endothelial growth factor A (VEGFA),vascular endothelial growth factor B (VEGFB),vascular endothelial growth factor C (VEGFC),tumor necrosis factor-α (TNFα),interleukin-1β (IL-1β),interleukin-6 (IL-6) and interleukin-8 (IL-8) in observation group were lower than those in control group,and the expression levels of decoy receptor 3 (DcR3) and cyclooxygenase-2 (COX-2) after treatment were also lower than those in control group (P<0.05).The 3 year survival rates in observation group and control group were 46.51% (20/43) and 30.23% (13/43),and the median survival times were 34.5 months and 26.7 months (P>0.05).There were no significant differences between the two groups in terms of incidence rates of adverse events (P>0.05).Conclusion Lapatinib combined with trastuzumab in the treatment of patients with HER2-positive breast cancer can reduce the levels of vascular endothelial factors and inflammatory factors and inhibit the releases of apoptotic factors,but has little effect on the 3-year survival rate of patients.

Key words: lapatinib, trastuzumab, human epidermal growth factor receptor-2 positive, breast cancer, survival