JCO:卡铂和紫杉醇对未知原发癌患者的部位特异性治疗:II期临床试验

2019-01-19 海北 MedSci原创

尽管基因表达谱是一种有前景的诊断技术,可以用于确定原发部位未知癌症(CUP)患者的起源组织,但是与经验化疗相比,没有临床试验评估该方法指导的位点特异性治疗的效果。

尽管基因表达谱是一种有前景的诊断技术,可以用于确定原发部位未知癌症(CUP)患者的起源组织,但是与经验化疗相比,没有临床试验评估该方法指导的位点特异性治疗的效果。因此,研究人员进行了一项随机研究,在先前未治疗的CUP患者中评估此类部位特异性治疗与经验化疗相比是否能改善预后。

研究人员通过微阵列分析进行全面的基因表达谱分析,并建立算法,用于预测肿瘤起源。 CUP患者被随机分配(11)接受标准部位特异性治疗或经验性紫杉醇和卡铂(PC)治疗。主要终点是1年生存率。

130名患者被随机分配并具有足够的活检组织用于分子分析。研究人员分别对50位和51位患者运用了位点特异性治疗和经验性PC治疗,并进行了功效分析。

最常见的癌症类型是胰腺癌(21%),癌(21%)和淋巴瘤20%)。位点特异性治疗和经验PC1年生存率分别为44.0%和54.9%(P = .264)。对于位点特异性治疗,中位总体和无进展存活分别为9.85.1个月,而经验PC12.54.8个月(P = .896.550)。比起反应较低的肿瘤,中位总生存期(16.7 v 10.6个月; P = .116)和无进展生存期(5.5 v 3.9个月; P = .018)对于预测的反应性较高的肿瘤类型更好。

因此,与经验PC相比,基于微阵列分析的位点特异性治疗并未导致1年生存率显着改善,尽管对原始部位的预测似乎具有一定的预后价值。


原始出处:

Hayashi H et al. Randomized Phase II Trial Comparing Site-Specific Treatment Based on Gene Expression Profiling With Carboplatin and Paclitaxel for Patients With Cancer of Unknown Primary Site. JCO, 2019; doi: 10.1200/JCO.18.00771. 


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    2019-09-05 lidong40
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    2019-01-19 Janeinair

    化疗经典了

    0

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