JCO:Dabrafenib和Trametinib治疗局部晚期或转移性BRAFV600突变甲状腺未分化癌

2017-10-30 MedSci MedSci原创

甲状腺未分化癌是一种高度恶性的肿瘤,患者确诊后平均生存时间只有5到12个月。且目前尚无有效的系统治疗方法。JCO近期发表了一篇文章,报道了BRAF抑制剂Dabrafenib和MEK抑制剂Trametinib联合治疗BRAFV600E突变甲状腺未分化癌的临床试验结果。

甲状腺未分化癌是一种高度恶性的肿瘤,患者确诊后平均生存时间只有5到12个月。且目前尚无有效的系统治疗方法。JCO近期发表了一篇文章,报道了BRAF抑制剂Dabrafenib和MEK抑制剂Trametinib联合治疗BRAFV600E突变甲状腺未分化癌的临床试验结果。

BRAFV600E突变的甲状腺未分化癌患者接受Dabrafenib 150mg每天两次联合Trametinib 2mg每天一次治疗,直至出现不可耐受毒性、疾病进展或患者死亡。主要的研究终点为研究者评估的总反应率。次要的研究终点包括反应持续时间,无进展生存,总生存和安全性。研究最终纳入16例BRAFV600E突变甲状腺未分化癌患者。所有的患者均接受过放疗或手术治疗,6例患者接受过系统治疗。总反应率为69%(11/16),7例患者在文章发表时仍有反应。由于缺少数据,平均反应持续时间、无进展生存和总生存未达到。安全性队列由7种罕见肿瘤组织学类型的共100例患者构成。常见的不良反应有虚弱(38%)、发热(37%)以及恶心(35%)。

文章最后认为,Dabrafenib联合Trametinib是第一个对BRAFV600E突变甲状腺未分化癌有稳定临床活性的治疗方法,且耐受性良好。该发现为这一罕见的甲状腺癌的治疗找到了突破点。

原始出处:
Vivek Subbiah,Robert J.Kreitman,et al.Dabrafenib and Trametinib Treatment in Patients With Locally Advanced or Metastatic BRAFV600-Mutant Anaplastic Thyroid Cancer.JCO.October 26 2017 doi:10.1200/JCO.2017.73.6785

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createdAvatar=null, createdBy=5d9225794204, createdName=siiner, createdTime=Sat Jun 30 12:37:00 CST 2018, time=2018-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1752366, encodeId=8f781e523663e, content=<a href='/topic/show?id=2cd11e738fd' target=_blank style='color:#2F92EE;'>#Trametinib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17738, encryptionId=2cd11e738fd, topicName=Trametinib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0da336510503, createdName=pandamao2022, createdTime=Tue Sep 25 20:37:00 CST 2018, time=2018-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2046027, encodeId=3ca7204602e7a, content=<a href='/topic/show?id=d9bb3152950' target=_blank style='color:#2F92EE;'>#分化癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31529, encryptionId=d9bb3152950, topicName=分化癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fca128, createdName=licz0423, createdTime=Thu Sep 27 06:37:00 CST 2018, time=2018-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896184, encodeId=26d3189618458, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Thu Dec 28 13:37:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656899, encodeId=7524165689910, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Sep 16 16:37:00 CST 2018, time=2018-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1891447, encodeId=3238189144ecd, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Mon Mar 05 05:37:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2027900, 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02 20:37:00 CST 2017, time=2017-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700319, encodeId=843b1e0031969, content=<a href='/topic/show?id=9799565312' target=_blank style='color:#2F92EE;'>#Dabrafenib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5653, encryptionId=9799565312, topicName=Dabrafenib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66be30051903, createdName=wujh_7312829, createdTime=Fri Jan 12 10:37:00 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1780444, encodeId=24471e8044430, content=<a href='/topic/show?id=786a3663f6' target=_blank style='color:#2F92EE;'>#BRAFV600#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3663, encryptionId=786a3663f6, topicName=BRAFV600)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1fa82500120, createdName=12498a1cm67暂无昵称, createdTime=Fri Dec 15 19:37:00 CST 2017, time=2017-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1664592, encodeId=bd44166459255, content=<a href='/topic/show?id=6df7698e65d' target=_blank style='color:#2F92EE;'>#甲状腺未分化癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69876, encryptionId=6df7698e65d, topicName=甲状腺未分化癌)], attachment=null, authenticateStatus=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Sep 16 16:37:00 CST 2018, time=2018-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1891447, encodeId=3238189144ecd, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Mon Mar 05 05:37:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2027900, encodeId=2f24202e900e7, content=<a href='/topic/show?id=597d366685' target=_blank style='color:#2F92EE;'>#BRAFV600突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3666, encryptionId=597d366685, topicName=BRAFV600突变)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c805395, createdName=ycmayy, createdTime=Sat Jun 30 04:37:00 CST 2018, time=2018-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650725, encodeId=333d1650e25a5, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Thu Nov 02 20:37:00 CST 2017, time=2017-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700319, encodeId=843b1e0031969, content=<a href='/topic/show?id=9799565312' target=_blank style='color:#2F92EE;'>#Dabrafenib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5653, encryptionId=9799565312, topicName=Dabrafenib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66be30051903, createdName=wujh_7312829, createdTime=Fri Jan 12 10:37:00 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2017-12-28 一闲
  6. [GetPortalCommentsPageByObjectIdResponse(id=1780444, encodeId=24471e8044430, content=<a href='/topic/show?id=786a3663f6' target=_blank style='color:#2F92EE;'>#BRAFV600#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3663, encryptionId=786a3663f6, topicName=BRAFV600)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1fa82500120, createdName=12498a1cm67暂无昵称, createdTime=Fri Dec 15 19:37:00 CST 2017, time=2017-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1664592, encodeId=bd44166459255, content=<a href='/topic/show?id=6df7698e65d' target=_blank style='color:#2F92EE;'>#甲状腺未分化癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69876, encryptionId=6df7698e65d, topicName=甲状腺未分化癌)], attachment=null, authenticateStatus=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Sep 16 16:37:00 CST 2018, time=2018-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1891447, encodeId=3238189144ecd, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Mon Mar 05 05:37:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2027900, encodeId=2f24202e900e7, content=<a href='/topic/show?id=597d366685' target=_blank style='color:#2F92EE;'>#BRAFV600突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3666, encryptionId=597d366685, topicName=BRAFV600突变)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c805395, createdName=ycmayy, createdTime=Sat Jun 30 04:37:00 CST 2018, time=2018-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650725, encodeId=333d1650e25a5, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Thu Nov 02 20:37:00 CST 2017, time=2017-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700319, encodeId=843b1e0031969, content=<a href='/topic/show?id=9799565312' target=_blank style='color:#2F92EE;'>#Dabrafenib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5653, encryptionId=9799565312, topicName=Dabrafenib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66be30051903, createdName=wujh_7312829, createdTime=Fri Jan 12 10:37:00 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-09-16 bsmagic9140
  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Sun Sep 16 16:37:00 CST 2018, time=2018-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1891447, encodeId=3238189144ecd, content=<a href='/topic/show?id=25b0102e2df' target=_blank style='color:#2F92EE;'>#JCO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10272, encryptionId=25b0102e2df, topicName=JCO)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6da1120, createdName=lidong40, createdTime=Mon Mar 05 05:37:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2027900, 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02 20:37:00 CST 2017, time=2017-11-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1700319, encodeId=843b1e0031969, content=<a href='/topic/show?id=9799565312' target=_blank style='color:#2F92EE;'>#Dabrafenib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5653, encryptionId=9799565312, topicName=Dabrafenib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66be30051903, createdName=wujh_7312829, createdTime=Fri Jan 12 10:37:00 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-03-05 lidong40
  8. 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  9. 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  10. 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