Lancet Oncol:帕妥珠单抗+曲妥珠单抗治疗HER2阳性转移性胆道癌的疗效和安全性

2021-08-04 Nebula MedSci原创

帕妥珠单抗和曲妥珠单抗的联合方案在既往治疗过的HER2阳性转移性胆道癌患者中的耐受性良好,而且有望获得较好的缓解率

转移性胆道癌的可用系统疗法很少,转移性胆道癌的中位总生存期短于一年。MyPathway研究评估了美国FDA批准的疗法在具有潜在活性分子变异的非适应症肿瘤中的治疗活性。

Javle等人对在MyPathway研究中接受双重抗HER2方案、帕妥珠单抗联合曲妥珠单抗治疗的携带HER2扩增和(或)过表达的转移性胆道癌患者进行了分析,分析结果于近日发表在了柳叶刀·肿瘤子刊上。

MyPathway研究是一项非随机、多中心、开放标签的2a期临床试验,招募了年满18岁的既往治疗过的携带HER2扩增和(或)过表达的转移性胆管癌患者,予以帕妥珠单抗(负荷剂量840 mg,随后每3周予以420 mg)联合曲妥珠单抗(负荷剂量8 mg/kg,随后每3周予以6 mg/kg)治疗。主要终点是调查员评估的客观缓解率。

2014年10月28日至2019年5月29日期间,MyPathway研究HER2胆管癌队列共招募了39位患者,于截止日期2020年3月10日时进行了抗肿瘤活性评估。

不同部位的胆管癌的治疗缓解情况

中位随访了8.1个月后。39位患者中有9位获得了部分缓解(客观缓解率 23%)。

无进展生存期(A)和总生存期(B)

18位(46%)患者报告了3-4级需紧急治疗的不良反应事件,最常见的是丙氨酸转氨酶和天门冬氨酸转氨酶升高(各5例[13%])。3位患者报告了与治疗相关的3级不良反应事件,包括丙氨酸转氨酶、天门冬氨酸转氨酶、血清碱性磷酸酶和血胆红素升高。

需紧急治疗的不良反应

10位(26%)患者报告了严重的需紧急治疗的不良反应,其中只有腹痛发生于不止一位患者(2例[5%])。无治疗相关严重不良反应事件、治疗相关4级不良事件或死亡病例。

综上所述,帕妥珠单抗和曲妥珠单抗的联合方案在既往治疗过的HER2阳性转移性胆道癌患者中的耐受性良好,而且有望获得较好的缓解率。

原始出处:

Milind Javle, et al. Pertuzumab and trastuzumab for HER2-positive, metastatic biliary tract cancer (MyPathway): a multicentre, open-label, phase 2a, multiple basket study. The Lancet Oncology. July 30, 2021. https://doi.org/10.1016/S1470-2045(21)00336-3

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    2021-12-02 minlingfeng
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    2021-11-28 howi
  4. 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  5. 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  6. 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  7. 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  8. 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time=2021-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1005324, encodeId=ded4100532413, content=负荷剂量联合, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJibu7hwJqpmHiaJgLLmJmcwp0WDTxWI3vqPBO1Mloq21VBOPqziapyibYatvd2QWHWicolL1vbVZHgpRQ/132, createdBy=d16a2107341, createdName=JZ Yang, createdTime=Thu Aug 05 11:19:35 CST 2021, time=2021-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033072, encodeId=204c10330e2d6, 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=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Wed Aug 04 02:05:22 CST 2021, time=2021-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034411, encodeId=355910344118d, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Wed Aug 04 02:05:22 CST 2021, time=2021-08-04, status=1, ipAttribution=)]
    2021-08-05 JZ Yang

    负荷剂量联合

    0

  9. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034411, encodeId=355910344118d, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Wed Aug 04 02:05:22 CST 2021, time=2021-08-04, status=1, ipAttribution=)]
    2021-08-04 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

  10. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034411, encodeId=355910344118d, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Wed Aug 04 02:05:22 CST 2021, time=2021-08-04, status=1, ipAttribution=)]
    2021-08-04 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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