Clin Cancer Res:III期临床研究CATNON表明IDH野生型的胶质母细胞瘤中,在放疗的基础上加用替莫唑胺并不能改善患者的预后

2022-03-14 网络 网络

研究表明,在IDH野生型的胶质母细胞瘤中,在放疗的基础上加用替莫唑胺并不能改善患者的预后。

近期,CLINICAL CANCER RESEARCH杂志上发表了一项III期临床研究CATNON (NCT00626990)的事后分析结果,主要是评估在IDH野生型的胶质母细胞瘤中,在放疗的基础上加用替莫唑胺是否提高患者的疗效。

在参与CATNON研究的751例患者中,有670例具有完全分子特征的肿瘤。其中159例符合世卫组织2021年IDH野生型胶质母细胞瘤分子标准。在这些患者中,47例(29.6%) 仅接受放疗,112例(70.4%) 接受放疗和替莫唑胺联合治疗。两组的特征类似,而联合组中MGMT启动子非甲基化肿瘤比例趋于更高(p=0.066)。

IDH野生型的胶质母细胞瘤患者的中位总生存期(OS)为1.4年(95% CI 1.3-1.8年),中位无进展生存期(PFS)为0.5年(95% CI 0.5-0.7年)。加入替莫唑胺对总生存期(HR=1.19, 95% CI 0.82-1.71)和无进展生存期(HR=0.87, 95% CI 0.61-1.24)均没有增加影响。

152例患者中,MGMT启动子甲基化有53例(34.9%),MGMT非甲基化有99例(65.1%)。MGMT甲基化肿瘤患者的总生存期优于非甲基化患者(HR=0.65, 95% CI 0.45-0.92); MGMT甲基化肿瘤组的中位总生存期为1.8年(95% CI 1.4-2.2年),MGMT非甲基化肿瘤组的中位总生存期为1.4年(95% CI 1.2-1.6年)。MGMT启动子甲基化对无进展生存期无影响(HR 0.95, 95%CI 0.68-1.34),MGMT甲基化肿瘤组的中位PFS为0.5年(95% CI 0.4 -0.8年),而MGMT非甲基化肿瘤组的中位PFS也是0.5年(95% CI 0.5-0.7年)。

 

同样,在MGMT启动子甲基化肿瘤组(HR 1.36, 95% CI 0.75-2.48)和MGMT非甲基化肿瘤组(HR 0.88, 95% CI 0.54-1.42)患者中,加入替莫唑胺均未检测到生存益处。

校正多因素的分析中,替莫唑胺的加入并不能较单独放疗改善患者的总生存期(HR=1.03, 95% CI 0.69-1.53)和无进展生存期(HR=0.79, 95% CI 0.55-1.13)。

综上,研究表明,在IDH野生型的胶质母细胞瘤中,在放疗的基础上加用替莫唑胺并不能改善患者的预后。

 

原始出处:

Tesileanu CMS, Sanson M, Wick W, Brandes AA,  et al. Temozolomide and radiotherapy versus radiotherapy alone in patients with glioblastoma, IDH-wildtype: post-hoc analysis of the EORTC randomized phase 3 CATNON trial. Clin Cancer Res. 2022 Mar 11:clincanres.4283.2021. doi: 10.1158/1078-0432.CCR-21-4283. Epub ahead of print. PMID: 35275197.

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time=2022-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476163, encodeId=cc1c14e616319, content=<a href='/topic/show?id=2bcee797732' target=_blank style='color:#2F92EE;'>#细胞瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77977, encryptionId=2bcee797732, topicName=细胞瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf5e7252474, createdName=spoonycyy, createdTime=Wed Mar 16 01:01:15 CST 2022, time=2022-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1524996, encodeId=067a1524996ef, content=<a href='/topic/show?id=4ba395994d' target=_blank style='color:#2F92EE;'>#II期临床#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9599, encryptionId=4ba395994d, topicName=II期临床)], attachment=null, 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    2022-05-11 juliusluan78
  8. 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