CLIN CANCER RES:Alisertib联合伊立替康和替莫唑胺治疗复发或难治性神经母细胞瘤

2018-12-20 MedSci MedSci原创

在I期试验中,含有伊立替康和替莫唑胺的alisertib片剂对神经母细胞瘤患者具有显着的抗肿瘤活性。CLIN CANCER RES近期发表了一篇文章,再次确认该方案的活性,评估alisertib口服液效果,并评估临床结局的生物学标志物。

在I期试验中,含有伊立替康和替莫唑胺的alisertib片剂对神经母细胞瘤患者具有显着的抗肿瘤活性。CLIN CANCER RES近期发表了一篇文章,再次确认该方案的活性,评估alisertib口服液效果,并评估临床结局的生物学标志物。

作者在复发或难治性神经母细胞瘤患者中进行了两阶段的II期试验,alisertib片剂(60 mg / m 2 ×7天),伊立替康(50 mg / m 2 静脉注射×5天)和替莫唑胺(100 mg / 100 m 2 口服×5天)。主要研究终点是最佳客观反应。在一个独立队列中使用alisertib 45mg / m 2口服溶液代替片剂。使用来自I期,II期和口服溶液队列的汇总数据来确定毒性,反应和无进展生存(PFS)的预测因素。研究分别在II期队列和口服溶液队列中治疗了20名和12名符合条件的患者。血液学毒性是最常见的不良事件。第二阶段,在19名可评估的患者(21%)中观察到部分反应。估计1年的PFS为34%。在口服溶液队列中,3名患者(25%)在第一个循环出现剂量限制性毒性(DLT)。与60mg / m 2的片剂相比,45mg / m 2的 Alisertib口服溶液中位C max更高和暴露更多。较高的alisertib浓度与第一周期DLT相关,而MYCN扩增与较差的PFS相关。

文章最后认为,这种药物组合具有抗肿瘤活性,特别是在MYCN非扩增肿瘤患者中。alisertib口服溶液的数据扩大了可用该药进行治疗的人群。

原始出处:

Steven G. DuBois, Yael P. Mosse, et al. Phase II Trial of Alisertib in Combination with Irinotecan and Temozolomide for Patients with Relapsed or Refractory Neuroblastoma. CLIN CANCER RES. December 2018 doi: 10.1158/1078-0432.CCR-18-1381

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    2018-12-22 freve

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