Lancet oncol:卡博替尼用于高度恶性的尤文肉瘤和骨肉瘤的疗效和安全性

2020-02-24 QQY MedSci原创

尤文肉瘤或骨肉瘤患者在确诊后的中位总生存期不到12个月,目前尚无标准疗法。在几个尤文肉瘤和肉瘤的预临床模型中,药理抑制MET信号和异常血管生成展现出一定治疗效果。研究人员开展一多中心的、单臂、两阶段的2期试验,招募年满12岁的ECOG表现状态0-1分的晚期尤文肉瘤或骨肉瘤患者,以评估MET和VEGFR2抑制剂卡博替尼(cabozantinib)用于这两种肿瘤的活性。予以卡博替尼(成人 60mg、儿

尤文肉瘤或骨肉瘤患者在确诊后的中位总生存期不到12个月,目前尚无标准疗法。在几个尤文肉瘤和肉瘤的预临床模型中,药理抑制MET信号和异常血管生成展现出一定治疗效果。

研究人员开展一多中心的、单臂、两阶段的2期试验,招募年满12岁的ECOG表现状态0-1分的晚期尤文肉瘤或骨肉瘤患者,以评估MET和VEGFR2抑制剂卡博替尼(cabozantinib)用于这两种肿瘤的活性。予以卡博替尼(成人 60mg、儿童[<16岁] 40mg/m2)口服、1/日,28天一疗程,直到病情进展、不可耐受的毒性、研究人员决定终止或患者撤出。尤文肉瘤的主要结点是6个月内的最佳客观缓解;骨肉瘤的是6个月内客观缓解和无进展的双重评估。

2015年4月16日-2018年7月12日,共招募了90位(尤文肉瘤和骨肉瘤各45人)患者。尤文肉瘤和骨肉瘤的中位随访时间分别是31.3个月和31.1个月。39位(87%)尤文肉瘤患者和42位(93%)骨肉瘤患者被纳入疗效评估。10位(26%)尤文肉瘤患者在6个月内获得客观缓解(都是部分缓解);5位骨肉瘤患者在6个月内获得客观缓解都是部分缓解),14位(33%)骨肉瘤患者6个月内无进展。最常见的3-4级不良反应事件是低磷酸盐血症(尤文肉瘤 5例、骨肉瘤 3例)、天冬氨酸转氨酶升高(2例、3例)、手足综合征(3例、2例)、气胸(2例、4例)和嗜中性粒细胞减少症(2例、4例)。90位患者中有61位(68%)至少发生过一次重度不良反应事件。无患者死于药物相关毒性作用。

卡博替尼用于晚期尤文肉瘤和骨肉瘤患者具有抗肿瘤活性,而且耐受性普遍良好。卡博替尼或可成为这类肿瘤的新的治疗选择,值得进一步研究。

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    2020-05-03 minlingfeng
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    2020-09-19 howi
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    2020-02-25 内科新手

    谢谢梅斯提供这么好的信息,学到很多

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