J CLIN ONCOL:III期选择性试验中年龄对lenvatinib治疗放射性碘难治性分化型甲状腺癌疗效和安全性的影响

2017-06-16 任露 MedSci原创

在lenvatinib治疗分化型甲状腺癌的研究中(E7o8o)中,lenvatinib与安慰剂相比, 显着延长了放射性碘难治性分化型甲状腺癌病人(RR-DTC)的无进展生存期(PFS)。预先设定的亚组分析研究了年龄对lenvatinib的疗效和安全性的影响。

目的:


在lenvatinib治疗分化型甲状腺癌的研究中中,lenvatinib与安慰剂相比,显着延长了放射性碘难治性分化型甲状腺癌病人(RR-DTC)的无进展生存期(PFS)。预先设定的亚组分析研究了年龄对lenvatinib的疗效和安全性的影响。

患者与方法:

这项随机、双盲、III期研究纳入经病理证实的RR-DTC病人,并按年龄分层(≤65或> 65岁)。患者(n = 392)接受lenvatinib 24毫克/天(n = 261)或安慰剂(n = 131)治疗。主要终点为PFS,次要终点包括总生存期(OS)、客观应答率和安全性。

结果:

在两个治疗组中,中位年龄分别为56岁(年轻组)和71岁(老年组)。在年轻和年老组中,lenvatinib与安慰剂相比PFS都获益,中位PFS分别为20.2个月vs3.2个月(危害比[HR],0.19;95%CI,0.13至0.27,p<..001)及16.7个月vs3.7个月(HR,0.27;95% CI,0.17至0.43;P< .001)。在任一治疗组,PFS没有随年龄而不同。在老年组中,用lenvatinib治疗的患者较安慰剂治疗的患者OS提高(HR,0.53;95% CI,0.31到0.91;P =0. 020)。年轻lenvatinib治疗组患者表现出显着提高的ORR(72% v 55%;P =0. 0038),与年老组相比,首次减量时间较长(3.7 vs 1.5个月),且≥3级与治疗相关的不良事件的比例较低(67% vs 89%;P<.001)。

结论:

这项亚组分析表明在两个年龄组中,用lenvatinib治疗较安慰剂提高了PFS,但在老年患者中观察到更高的毒性反应。即使疾病进展后,老年患者的OS仍获益,提示lenvatinib可以考虑治疗任何年龄的RR-DTC患者。

原始出处:

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    2018-04-19 juliusluan78
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    2018-05-21 minlingfeng
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time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594479, encodeId=66b315944e984, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sun Jun 18 04:19:00 CST 2017, time=2017-06-18, status=1, ipAttribution=)]
    2017-06-25 xuyihan

    非常不错学习

    0

  6. 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time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1594479, encodeId=66b315944e984, content=<a href='/topic/show?id=b317956200' target=_blank style='color:#2F92EE;'>#III期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9562, encryptionId=b317956200, topicName=III期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sun Jun 18 04:19:00 CST 2017, time=2017-06-18, status=1, ipAttribution=)]
    2017-06-18 tastas
  9. 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    2017-06-18 freve
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