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J Clin Oncol：nab-西罗莫司有望成为恶性PEComa的治疗选择！

2021-10-14 Nebula MedSci原创

PEComanab-西罗莫司
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恶性血管周围上皮样细胞瘤 (PEComa) 是一种罕见的侵袭性肉瘤，nab-西罗莫司有望成为恶性PEComa的治疗选择！

恶性血管周围上皮样细胞瘤 (PEComa) 是一种罕见的侵袭性肉瘤，由组织学和免疫组织化学上独特的上皮样细胞组成。大多数PEComas在临床上是良性的并且不会转移，但恶性PEComa会表现出局部浸润和/或转移性扩散。目前尚无获批的治疗药物/方案。

nab-Sirolimus for Patients With Malignant Perivascular Epithelioid Cell Tumors

这是一项前瞻性的单臂的II期临床试验，是首个评估雷帕霉素靶点抑制剂nab-西罗莫司在PEComa患者中的疗效和安全性的研究。恶性PEComa患者接受nab-西罗莫司治疗（ 100 mg/m2/周，静滴，连用两周，停一周）。主要终点是客观缓解率。次要终点包括缓解持续时间、无进展生存期和安全性。探索性终点是肿瘤标志物分析。

缓解率

共有34位患者接受了治疗（安全性评估），31位患者被纳入疗效分析。总缓解率为39%（12/31；95% CI 22-58），包括1例完全缓解和11例部分缓解；52%（16/31）的患者病情稳定，10%（3/31）的患者病情发生进展。缓解获得较快（67%的在第6周即已获得），而且持久。中位随访了2.5年后，中位缓解持续时间仍未达到。

无进展生存期

31位患者中有25位有肿瘤突变谱：9位携带TSC2突变的患者中有8位（89%）获得了缓解，相比之下，16位不携带TSC2突变的患者中只有两位（13%）获得缓解（p<0.001）。中位无进展生存期为10.6个月（95% CI 5.5-未达到），中位总生存期为40.8个月（95% CI 22.2-未达到）。

最常见的治疗相关的不良反应多少1-2级的。无4级及以上的治疗相关不良事件发生。

综上所述，nab-西罗莫司在恶性PEComa患者中具有治疗活性。缓解率、缓解持续时间、疾病控制率和安全性均支持nab-西罗莫司成为该种恶性肿瘤的重要治疗选择。

原始出处：

Andrew J. Wagner, et al. nab-Sirolimus for Patients With Malignant Perivascular Epithelioid Cell Tumors. Journal of Clinical Oncology. October 12, 2021. https://ascopubs.org/doi/full/10.1200/JCO.21.01728

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    2022-07-25 feather89

    #PE#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1729153, encodeId=e68e1e29153bd, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Jul 25 06:50:14 CST 2022, time=2022-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866285, encodeId=5f37186628565, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Sep 28 21:50:14 CST 2022, time=2022-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1772754, encodeId=35011e72754df, content=<a href='/topic/show?id=871064e139b' target=_blank style='color:#2F92EE;'>#治疗选择#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64713, encryptionId=871064e139b, topicName=治疗选择)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=015a38388258, createdName=liye789132264, createdTime=Thu Nov 04 04:50:14 CST 2021, time=2021-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340054, encodeId=853f1340054bc, content=<a href='/topic/show?id=8c519053e85' target=_blank style='color:#2F92EE;'>#西罗莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90537, encryptionId=8c519053e85, topicName=西罗莫司)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/JHX80Wpw3cstP6RtQ1pO8asyNiah0uIJwh7hmKm1emARpicBibTeQrj1SN7YwGSwibOrIL2kZ9WHmRiaznSnuHhUJUg/132, createdBy=c7de2500155, createdName=ms3415360956839622, createdTime=Sat Oct 16 01:50:14 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
    2022-09-28 minlingfeng

    #Oncol#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1729153, encodeId=e68e1e29153bd, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Jul 25 06:50:14 CST 2022, time=2022-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866285, encodeId=5f37186628565, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Sep 28 21:50:14 CST 2022, time=2022-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1772754, encodeId=35011e72754df, content=<a href='/topic/show?id=871064e139b' target=_blank style='color:#2F92EE;'>#治疗选择#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64713, encryptionId=871064e139b, topicName=治疗选择)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=015a38388258, createdName=liye789132264, createdTime=Thu Nov 04 04:50:14 CST 2021, time=2021-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340054, encodeId=853f1340054bc, content=<a href='/topic/show?id=8c519053e85' target=_blank style='color:#2F92EE;'>#西罗莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90537, encryptionId=8c519053e85, topicName=西罗莫司)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/JHX80Wpw3cstP6RtQ1pO8asyNiah0uIJwh7hmKm1emARpicBibTeQrj1SN7YwGSwibOrIL2kZ9WHmRiaznSnuHhUJUg/132, createdBy=c7de2500155, createdName=ms3415360956839622, createdTime=Sat Oct 16 01:50:14 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
    2021-11-04 liye789132264

    #治疗选择#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1729153, encodeId=e68e1e29153bd, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Jul 25 06:50:14 CST 2022, time=2022-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866285, encodeId=5f37186628565, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Sep 28 21:50:14 CST 2022, time=2022-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1772754, encodeId=35011e72754df, content=<a href='/topic/show?id=871064e139b' target=_blank style='color:#2F92EE;'>#治疗选择#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64713, encryptionId=871064e139b, topicName=治疗选择)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=015a38388258, createdName=liye789132264, createdTime=Thu Nov 04 04:50:14 CST 2021, time=2021-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340054, encodeId=853f1340054bc, content=<a href='/topic/show?id=8c519053e85' target=_blank style='color:#2F92EE;'>#西罗莫司#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=90537, encryptionId=8c519053e85, topicName=西罗莫司)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/JHX80Wpw3cstP6RtQ1pO8asyNiah0uIJwh7hmKm1emARpicBibTeQrj1SN7YwGSwibOrIL2kZ9WHmRiaznSnuHhUJUg/132, createdBy=c7de2500155, createdName=ms3415360956839622, createdTime=Sat Oct 16 01:50:14 CST 2021, time=2021-10-16, status=1, ipAttribution=)]
    2021-10-16 ms3415360956839622

    #西罗莫司#

    0