進行性三重陰性乳がんにおける併用療法の有効性(Combination Therapy Improves Outcomes for Advanced Triple-Negative Breast Cancer)

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2025-08-21 マウントサイナイ医療システム(MSHS)

マウントサイナイ医科大学(Icahn School of Medicine)の研究チームが実施した第2相ランダム化臨床試験の結果、進行したトリプルネガティブ乳がん(TNBC)に対し、カルボプラチン+エベロリムスの併用療法が単独カルボプラチンより有効であることが示されました。併用群では病勢進行または死亡リスクが52%減少し、耐性の強いTNBC治療に新たな選択肢となる可能性が浮上しています。また治療は良好に耐えられ、安全性にも問題は認められませんでした。TNBCの多くは細胞増殖制御に関わるPTEN遺伝子が欠失し、mTOR経路が過活性化していますが、エベロリムスはこの経路を阻害することで抗腫瘍効果を発揮すると考えられます。これらの結果はさらなる第3相試験による検証が必要ですが、TNBC患者に対する治療戦略の進展に寄与する重要な一歩です。

<関連情報>

進行性トリプルネガティブ乳がんに対する単剤カルボプラチンとカルボプラチンとエベロリムスの組み合わせのランダム化第 II 相比較試験 Randomized phase II comparison of single-agent carboplatin versus combination of carboplatin and everolimus for advanced triple negative breast cancer

Rima Patel,Jami Fukui,Paula Klein,Erin Moshier,Hulya Kocyigit,Laura Fiedler,Weronika Bucwinska,Xiao Y. Xing,Charles Shapiro,Anupama Goel,Julie Fasano,Theresa Shao,Aarti Bhardwaj,Esther Kim,Rita Vaccaro,Karen Lee,Eric Wilck & Amy Tiersten
Breast Cancer Research and Treatment  Published:16 August 2025
DOI:https://doi.org/10.1007/s10549-025-07802-7

進行性三重陰性乳がんにおける併用療法の有効性(Combination Therapy Improves Outcomes for Advanced Triple-Negative Breast Cancer)

Abstract

Purpose

Triple-negative breast cancers (TNBCs) are associated with a high frequency of PTEN loss, which can lead to activation of the mTOR pathway and tumor proliferation but may be reversible with the mTOR inhibitor everolimus. A prior phase II single-arm trial of carboplatin and everolimus in patients with advanced TNBC demonstrated good tolerability and preliminary efficacy.

Patients and methods

A phase II randomized trial in patients with advanced TNBC, with 0–3 prior lines of therapy, was conducted. Patients were randomized 2:1 to receive carboplatin and everolimus or carboplatin alone. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), overall response rate (ORR), clinical benefit rate (CBR), and safety.

Results

Between 2015 and 2022, 59 patients were randomized to carboplatin/everolimus (n = 38) or carboplatin alone (n = 21). The median age of the population was 62 years and 68% had received at least one prior line of therapy. Median PFS was significantly improved in patients who received carboplatin/everolimus (4.7 months) versus carboplatin alone (4.2 months; HR:0.49; 95% CI: 0.25–0.98; p = 0.0390). OS was 17.6 months with the combination and 14.6 months with carboplatin alone (HR:1.17; 95% CI: 0.59–2.30; p = 0.6593). The most common adverse events (AEs) on the combination included thrombocytopenia, anemia, leukopenia, and neutropenia.

Conclusion

The combination of carboplatin and everolimus in this study reduced the risk of progression or death by 52%. The regimen was well tolerated and provides a promising treatment option for patients with advanced TNBC.

医療・健康
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