Lancet Oncol:曲妥珠单抗+帕妥珠单抗+化疗不能延长HER2阳性转移性胃或胃食管交界癌患者总生存期

2018-09-12 zhangfan MedSci原创

研究认为曲妥珠单抗+帕妥珠单抗+化疗一线治疗HER2阳性转移性胃或胃食管交界癌的疗效不显著

在曲妥珠单抗联合化疗的基础上添加帕妥珠单抗可提高HER2阳性早期及转移性乳腺癌患者的生存期。近日研究人员考察了曲妥珠单抗+帕妥珠单抗+化疗用于一线治疗HER2阳性转移性食管交界癌的疗效。

JACOB为一项双盲、安慰剂对照、随机多中心III期临床研究,成年的HER2阳性转移性胃或胃食管交界癌患者参与。197名患者在曲妥珠单抗(起始剂量8mg/kg,随后每3周接受6 mg/kg维持治疗)联合化疗(顺铂+卡培他滨或5-氟尿嘧啶)基础上,随机接受帕妥珠单抗(840mg)或安慰剂,研究的主要终点为无进展生存期。

帕妥珠单抗组388人,安慰剂组392人参与研究,平均随访24-25个月。帕妥珠单抗组死亡242人,安慰剂组死亡262人。组间总生存期差异不显著(帕妥珠单抗vs安慰剂,17.5个月vs 14.2个月,HR=0.84)。45%的帕妥珠单抗患者以及39%的安慰剂患者出现严重不良事件,其中腹泻最常见。常见的3-5级不良事件包括中性粒细胞减少、贫血和腹泻,对照组发生7例治疗相关死亡 ,帕妥珠单抗组未发生治疗导致的患者死亡。

研究认为曲妥珠单抗+帕妥珠单抗+化疗一线治疗HER2阳性转移性胃或胃食管交界癌的疗效不显著。

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    2019-05-03 howi
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    2019-07-19 minlingfeng
  4. [GetPortalCommentsPageByObjectIdResponse(id=1829804, encodeId=f432182980483, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri May 03 04:20:00 CST 2019, time=2019-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648130, encodeId=1ffe1648130bd, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a67b23554000, 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encryptionId=87828339e7a, topicName=胃食管)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sat Dec 01 09:20:00 CST 2018, time=2018-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308513, encodeId=0796130851330, content=<a href='/topic/show?id=240f8e3234' target=_blank style='color:#2F92EE;'>#HER2阳性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8732, encryptionId=240f8e3234, topicName=HER2阳性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8409354, createdName=闆锋旦, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378188, encodeId=9f0413e818870, content=<a href='/topic/show?id=c29b69004f9' target=_blank style='color:#2F92EE;'>#生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69004, encryptionId=c29b69004f9, topicName=生存期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386419, encodeId=b9b213864198e, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437365, encodeId=5c51143e36578, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516013, encodeId=8ff1151601331, content=<a href='/topic/show?id=bd0152e64f1' target=_blank style='color:#2F92EE;'>#总生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52764, encryptionId=bd0152e64f1, topicName=总生存期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bdf610907545, createdName=12498cb5m16暂无昵称, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1584925, encodeId=70cf15849250e, content=<a href='/topic/show?id=e32f83401c1' target=_blank style='color:#2F92EE;'>#胃食管交界癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83401, encryptionId=e32f83401c1, topicName=胃食管交界癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=726e17069198, createdName=ms1260584454294838, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1829804, encodeId=f432182980483, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri May 03 04:20:00 CST 2019, time=2019-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648130, encodeId=1ffe1648130bd, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a67b23554000, createdName=linlin2320, createdTime=Mon Mar 11 18:20:00 CST 2019, time=2019-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865534, encodeId=5538186553474, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Fri Jul 19 05:20:00 CST 2019, time=2019-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1948562, encodeId=ed3e194856257, content=<a href='/topic/show?id=87828339e7a' target=_blank style='color:#2F92EE;'>#胃食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83397, encryptionId=87828339e7a, topicName=胃食管)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sat Dec 01 09:20:00 CST 2018, time=2018-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308513, encodeId=0796130851330, content=<a href='/topic/show?id=240f8e3234' target=_blank style='color:#2F92EE;'>#HER2阳性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8732, encryptionId=240f8e3234, topicName=HER2阳性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8409354, createdName=闆锋旦, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378188, encodeId=9f0413e818870, content=<a href='/topic/show?id=c29b69004f9' target=_blank style='color:#2F92EE;'>#生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69004, encryptionId=c29b69004f9, topicName=生存期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386419, encodeId=b9b213864198e, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437365, encodeId=5c51143e36578, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516013, encodeId=8ff1151601331, content=<a href='/topic/show?id=bd0152e64f1' target=_blank style='color:#2F92EE;'>#总生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52764, encryptionId=bd0152e64f1, topicName=总生存期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bdf610907545, createdName=12498cb5m16暂无昵称, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1584925, encodeId=70cf15849250e, content=<a href='/topic/show?id=e32f83401c1' target=_blank style='color:#2F92EE;'>#胃食管交界癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83401, encryptionId=e32f83401c1, topicName=胃食管交界癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=726e17069198, createdName=ms1260584454294838, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1829804, encodeId=f432182980483, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri May 03 04:20:00 CST 2019, time=2019-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648130, encodeId=1ffe1648130bd, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a67b23554000, 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target=_blank style='color:#2F92EE;'>#生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69004, encryptionId=c29b69004f9, topicName=生存期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386419, encodeId=b9b213864198e, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1437365, encodeId=5c51143e36578, content=<a href='/topic/show?id=0e311010591a' target=_blank style='color:#2F92EE;'>#食管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101059, encryptionId=0e311010591a, topicName=食管)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516013, encodeId=8ff1151601331, content=<a href='/topic/show?id=bd0152e64f1' target=_blank style='color:#2F92EE;'>#总生存期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52764, 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  7. [GetPortalCommentsPageByObjectIdResponse(id=1829804, encodeId=f432182980483, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri May 03 04:20:00 CST 2019, time=2019-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648130, encodeId=1ffe1648130bd, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a67b23554000, 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  8. [GetPortalCommentsPageByObjectIdResponse(id=1829804, encodeId=f432182980483, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Fri May 03 04:20:00 CST 2019, time=2019-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648130, encodeId=1ffe1648130bd, content=<a href='/topic/show?id=d5c560226fc' target=_blank style='color:#2F92EE;'>#曲妥珠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60226, encryptionId=d5c560226fc, topicName=曲妥珠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a67b23554000, 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encryptionId=bd0152e64f1, topicName=总生存期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bdf610907545, createdName=12498cb5m16暂无昵称, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1584925, encodeId=70cf15849250e, content=<a href='/topic/show?id=e32f83401c1' target=_blank style='color:#2F92EE;'>#胃食管交界癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83401, encryptionId=e32f83401c1, topicName=胃食管交界癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=726e17069198, createdName=ms1260584454294838, createdTime=Fri Sep 14 00:20:00 CST 2018, time=2018-09-14, status=1, ipAttribution=)]
    2018-09-14 zhouqu_8
  9. 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  10. 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