Eur J Cancer:MEK抑制剂治疗NRAS突变型转移性黑色素瘤的真实临床疗效

2022-03-15 xiaozeng MedSci原创

MEK抑制剂治疗NRAS突变型转移性黑色素瘤的真实临床疗效可期。

在随机对照试验中,MEK抑制剂 (MEKi) 已显示出了对携带NRAS突变的转移性黑色素瘤的临床疗效,但是它们的临床应用目前局限于晚期、预处理过的患者,这与以前的试验情况不同。目前关于MEK抑制剂在真实临床上的疗效的数据很少。

本研究是一项回顾性的多中心研究,评估了在五个德国癌症中心接受MEK抑制剂治疗的黑色素瘤患者(既往至少接受过一次治疗)的临床病程。主要终点是缓解率。

共招募了33位患者,包括19位男性(58%)和14位女性(42%),中位年龄64岁。91%的患者既往采用过免疫检查点抑制剂治疗,90%的患者在治疗开始时有血清乳酸脱氢酶(LDH)水平升高,33%的患者已发生了脑转移,30%的患者ECOG表现状态≥2分。

无进展生存率

中位随访了10.0个月后,总缓解率为18.2%(都是部分缓解),疾病控制率为48.5%。中位缓解持续时间是6.8个月,中位无进展生存期为7.1个月,中位总生存期为7.1个月。在亚组分析中,无论LDH水平高低、有无脑转移,MEK抑制剂在该研究患者中的临床疗效相似;与女性患者相比,男性患者采用MEK抑制剂治疗的效果更好;与其他MEK抑制剂相比,曲美替尼的疗效略胜一筹,但这可能是选择偏倚造成的。总体上,与既往临床试验相比,MEK抑制剂在真实临床中的疗效无明显差异。

总生存率

 

82%的患者经历了不良反应事件。最常见的是痤疮样皮疹(55%),其次是外周水肿(33%)。3位患者 (9%) 因不良反应而不得不暂时或永久性地减少MEK抑制剂的剂量。

综上,MEK抑制剂在NRAS突变的晚期黑色素瘤患者中的真实临床疗效与在临床试验中的相当

 

原始出处:

Salzmann Martin,Pawlowski Johannes,Loquai Carmen et al. MEK inhibitors for pre-treated, NRAS-mutated metastatic melanoma: A multi-centre, retrospective study.[J] .Eur J Cancer, 2022, 166: 24-32. https://doi.org/10.1016/j.ejca.2022.02.008.

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    2022-04-05 sunylz
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    2023-01-31 tcm99hq
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  6. 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  7. [GetPortalCommentsPageByObjectIdResponse(id=1680791, encodeId=bc001680e913e, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Tue Apr 05 04:25:25 CST 2022, time=2022-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079847, encodeId=73c820e984747, content=<a href='/topic/show?id=8b5e1302933' target=_blank style='color:#2F92EE;'>#NRAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13029, encryptionId=8b5e1302933, topicName=NRAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Tue Jan 31 00:25:25 CST 2023, time=2023-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1947608, encodeId=9371194e608d0, content=<a href='/topic/show?id=1d2513030c6' target=_blank style='color:#2F92EE;'>#NRAS突变#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13030, encryptionId=1d2513030c6, topicName=NRAS突变)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKxsKDoOOFxGpMibw6lsQFUIicWt7kWGevkdgFhjiban1icD2JdIBmjVo7qX7aSlCSpiaia382nuLKiaI3Cg/132, createdBy=5c442500150, createdName=ms9474365431325850, createdTime=Wed Jun 15 20:25:25 CST 2022, time=2022-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1793114, encodeId=45801e9311475, content=<a href='/topic/show?id=ced215146b3' target=_blank style='color:#2F92EE;'>#RAS突变型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15146, encryptionId=ced215146b3, topicName=RAS突变型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cb02500048, createdName=ms6832696159214430, createdTime=Fri Nov 04 22:25:25 CST 2022, time=2022-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1907222, encodeId=51cd190e222d9, content=<a href='/topic/show?id=acc02289e40' target=_blank style='color:#2F92EE;'>#临床疗效#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22897, encryptionId=acc02289e40, topicName=临床疗效)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8346212, createdName=respect, createdTime=Fri Sep 16 05:25:25 CST 2022, time=2022-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2041435, 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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sun Dec 11 04:25:25 CST 2022, time=2022-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943933, encodeId=f5fd194393392, content=<a href='/topic/show?id=d2af1152597' target=_blank style='color:#2F92EE;'>#MEK#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11525, encryptionId=d2af1152597, topicName=MEK)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b0e350, createdName=naiwu77, createdTime=Mon Oct 10 03:25:25 CST 2022, time=2022-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361589, encodeId=94b513615894d, content=<a href='/topic/show?id=bcd093445b5' target=_blank style='color:#2F92EE;'>#转移性黑色素瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93445, encryptionId=bcd093445b5, topicName=转移性黑色素瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d39f177, createdName=lixiao3326, createdTime=Wed Mar 16 12:25:25 CST 2022, time=2022-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386959, encodeId=b47e138695984, 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=39, 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=Wed Mar 16 12:25:25 CST 2022, time=2022-03-16, status=1, ipAttribution=)]
    2022-12-11 jklm09
  8. 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topicName=null, topicId=null, topicList=[TopicDto(id=93445, encryptionId=bcd093445b5, topicName=转移性黑色素瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d39f177, createdName=lixiao3326, createdTime=Wed Mar 16 12:25:25 CST 2022, time=2022-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386959, encodeId=b47e138695984, 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=39, 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=Wed Mar 16 12:25:25 CST 2022, time=2022-03-16, status=1, ipAttribution=)]
    2022-10-10 naiwu77
  9. 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topicName=null, topicId=null, topicList=[TopicDto(id=93445, encryptionId=bcd093445b5, topicName=转移性黑色素瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d39f177, createdName=lixiao3326, createdTime=Wed Mar 16 12:25:25 CST 2022, time=2022-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386959, encodeId=b47e138695984, 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=39, 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=Wed Mar 16 12:25:25 CST 2022, time=2022-03-16, status=1, ipAttribution=)]
  10. 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