JCO:晚期黑色素瘤患者使用纳武单抗单药疗法的安全性综合分析

2016-11-21 MedSci MedSci原创

该试验进行回顾性分析,以评估纳武单抗单药使用在晚期黑色素瘤患者中的安全性,并评定其不良反应事件,制定安全使用须知。

该试验进行回顾性分析,以评估纳武单抗单药使用在晚期黑色素瘤患者中的安全性,并评定其不良反应事件,制定安全使用须知。

该回顾性分析数据包括四部分试验,其中包括两个三期临床试验,患者使用药品方式为3 mg / kg,每2周1次。分析包括相关不良反应事件(AE)发生率,选择性AE事件(与潜在免疫学病因相关)的发生时间与分辨率,选择性AE事件与抑制性免疫调节剂(IM)对抗肿瘤功效的影响。


分析结果显示,576例患者中,71%(95%CI,67%~75%)的患者出现不同程度的与药品使用相关的不良事件。最常见为疲劳(25%),瘙痒(17%),腹泻(13%)和皮疹(13%)。有10%的患者出现3~4级不良反应事件。无药物使用相关死亡事件发生。选择性AE事件(发生在49%的患者中)中常见的为皮肤相关反应,消化道反应,内分泌与肝脏反应。3~4级选择性AE发生率为4%。中位选择性AE发病时间范围从5周(皮肤反应)到15周(肾衰竭)。大约有24%的患者出现选择性AE事件后。经过系统性免疫调节治疗后得到缓解。出现了任何级别的选择性AE事件的患者在经过剂量调整后,其ORR均高于未出现者。经过系统性免疫调节治疗与未经过治疗的患者其ORR无显著性差异。

分析结果可以看出,与纳武单抗单药使用相关的AE时间基本为低级别,且遵循既定的安全用药须知使用基本可得到缓解。使用免疫调节治疗不会影响患者的ORR,尽管选择性AE发生率与ORR存在线性相关,但PFS上无明显获益。

原始出处:Weber JS, Hodi FS, Wolchok JD, Topalian SL, Schadendorf D, Larkin J, et al. Safety Profile of Nivolumab Monotherapy: A Pooled Analysis of Patients With Advanced Melanoma. Journal of Clinical Oncology;0:JCO.2015.66.1389.

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    2017-09-10 siiner
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    2017-04-13 lidong40
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    2017-06-24 sunylz
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    2016-12-05 laoli

    谢谢分享!

    0

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    2016-11-21 doctorJiangchao

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