Clin Cancer Res:口服选择性雌激素受体降解剂±Ribociclib或Alpelisib治疗ER+乳腺癌的疗效和安全性

2021-08-30 Nebula MedSci原创

口服选择性雌激素受体降解剂±Ribociclib或Alpelisib治疗ER+乳腺癌的安全性良好,而且表现出初步的抗肿瘤活性

雌激素受体α(ER)信号通路在大部分乳腺癌的发展过程中起关键作用。ER 阳性乳腺癌的内分泌治疗(ET)通过多种机制靶向这条通路,包括芳香化酶抑制剂耗竭雌激素、选择性 ER 调节剂的应用和选择性ER降解剂(SERD) 破坏雌激素结合和耗竭 ER。

目前,关于癌症治疗中口服 SERD 的数据很少。本研究是一项多中心、开放标签的剂量递增的I期研究,评估了口服 SERD LSZ102 单用(A 组;n=77)或联合 Ribociclib (B 组;n=78)或 Alpelisib(C 组;n=43)用于经组织学证实的、经过大量预处理的、既往病情进展过的 ER 阳性乳腺癌成人患者安全性和初步活性。

研究流程

A组:LSZ102 200-900 mg/天;B组:LSZ102 200-600 mg/天 +Ribociclib 300-600 mg/天;C组:LSZ102 300-450 mg/天+Alpelisib 200-300 mg/天。主要终点是首个28天疗程时的剂量限制性毒性(DLT)、不良事件(AE)、实验室参数、药代动力学、活检 ER 蛋白和调查员评估的临床缓解率。

各组不良事件发生情况

最常见的 AE 为胃肠道事件。10%的受试者发生了与治疗相关的重度 AE,最多见于 C 组(23%)。A 组、B 组和 C 组的 DLT 的发生率分别是5%、3%和19%。LSZ102 暴露略大于剂量比例。在治疗过程中,活检 ER 阳性率减少,变化趋势与 LSZ102 剂量反应一致。

A 组、B 组和 C 组的客观缓解率分别为1.3%(95%CI 0.0-7.0)、16.9%(9.3-27.1)和7.0%(1.5-19.1);临床获益率分别为7.8%(2.9-16.2)、35.1%(24.5-46.8)和20.9%(10.0-36.0)。

综上,LSZ102 单独使用和与 Ribociclib 联合使用时的耐受性良好,而且与 Alpelisib 联合使用时的安全性也可控。此外,在联合使用中也观察到了初步临床活性。

原始出处:

Komal Jhaveri, et al. A Phase I Study of LSZ102, an Oral Selective Estrogen Receptor Degrader, With or Without Ribociclib or Alpelisib, in Patients with Estrogen Receptor-Positive Breast Cancer. Clinical Cancer Research. DOI: 10.1158/1078-0432.CCR-21-1095

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    2022-06-03 jiekemin
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    2022-03-07 ms1000001687352890

    继续学习

    0

  4. 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encryptionId=bc7a1545e44, topicName=ribociclib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2f558440263, createdName=般若傻瓜, createdTime=Wed Sep 01 10:50:32 CST 2021, time=2021-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503502, encodeId=6bd9150350242, content=<a href='/topic/show?id=59d798e61f0' target=_blank style='color:#2F92EE;'>#雌激素受体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98761, encryptionId=59d798e61f0, topicName=雌激素受体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae6c9649886, createdName=surilei, createdTime=Wed Sep 01 10:50:32 CST 2021, time=2021-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1605245, encodeId=affc16052454b, content=<a href='/topic/show?id=fe7f2346eb' target=_blank style='color:#2F92EE;'>#Alpelisib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2346, encryptionId=fe7f2346eb, topicName=Alpelisib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=859419357438, createdName=12498561m38(暂无昵称), createdTime=Wed Sep 01 10:50:32 CST 2021, time=2021-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1625852, encodeId=a9ea1625852d7, content=<a href='/topic/show?id=bc29140196e' target=_blank style='color:#2F92EE;'>#PEL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14019, encryptionId=bc29140196e, topicName=PEL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=399320916411, createdName=tidiq, createdTime=Wed Sep 01 10:50:32 CST 2021, time=2021-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033106, encodeId=a14f1033106f6, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Aug 30 22:50:32 CST 2021, time=2021-08-30, status=1, ipAttribution=)]
    2022-05-23 feather89
  5. 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encryptionId=bc7a1545e44, topicName=ribociclib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2f558440263, createdName=般若傻瓜, createdTime=Wed Sep 01 10:50:32 CST 2021, time=2021-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1503502, encodeId=6bd9150350242, content=<a href='/topic/show?id=59d798e61f0' target=_blank style='color:#2F92EE;'>#雌激素受体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98761, encryptionId=59d798e61f0, topicName=雌激素受体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae6c9649886, createdName=surilei, createdTime=Wed Sep 01 10:50:32 CST 2021, time=2021-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1605245, encodeId=affc16052454b, content=<a href='/topic/show?id=fe7f2346eb' target=_blank style='color:#2F92EE;'>#Alpelisib#</a>, beContent=null, 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encodeId=a14f1033106f6, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Mon Aug 30 22:50:32 CST 2021, time=2021-08-30, status=1, ipAttribution=)]
  6. 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  7. 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  8. 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    2021-09-01 tidiq
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    2021-08-30 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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