JCO:拉帕替尼联用卡培他滨和奥沙利铂并不延长胃癌患者总生存时间

2015-12-03 zhaozhou 译 MedSci原创

 胃癌是世界第三大癌症。对于胃癌的治疗,目前仍没有标准的一线化疗药物,但是现有的治疗选择包括了氟尿嘧啶和铂类药物如顺铂或奥沙利铂联用。尽管细胞毒性疗法取得的长足的进步,但是对于转移性癌症患者来讲,生存期仍然很短暂,只有少数患者能在治疗后存活超过两年。人表皮生长因子受体2(HER2)和大约20%的胃食道癌有关。 为了评价卡培他滨和奥沙利铂(CapeOx)加上拉帕替尼来治疗未曾接受

胃癌是世界第三大癌症。对于胃癌的治疗,目前仍没有标准的一线化疗药物,但是现有的治疗选择包括了氟尿嘧啶和铂类药物如顺铂或奥沙利铂联用。尽管细胞毒性疗法取得的长足的进步,但是对于转移性癌症患者来讲,生存期仍然很短暂,只有少数患者能在治疗后存活超过两年。人表皮生长因子受体2(HER2)和大约20%的胃食道癌有关。
 

为了评价卡培他滨和奥沙利铂(CapeOx)加上拉帕替尼来治疗未曾接受过治疗的HER2阳性晚期胃食道腺癌的有效性,研究人员开展了一项三期临床试验。HER2阳性晚期胃食道腺癌患者被随机分成两组,每天服用CapeOx加拉帕替尼1250mg或安慰剂。主要结束终点是总生存时间(OS)。试验结果显示,拉帕替尼组合安慰剂对照组的中位OS分别为12.2和10.5个月,二者并没有显著性差异。拉帕替尼组和安慰剂组的中位无进展生存时间分别为6.0和5.4个月。拉帕替尼组的反应率为53%,显著高于安慰剂对照组的39%。亚组分析表明拉帕替尼组的OS在亚洲人和年轻患者中更长。拉帕替尼组有更高的毒性反应,尤其是腹泻。
 
此次研究表明,CapeOx加上拉帕替尼并没有显著延长HER2阳性胃食道腺癌患者的总生存时间。但是,对于患者所处地域和年龄来说,这种用药方式有着显著性差异。因此,还需要深入研究这一关联。

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    2015-12-26 lidong40
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    2015-12-27 hixiaoluo

    好文章,值得收藏

    0

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    2015-12-10 jetleo

    亚洲人还是更好些

    0

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