Aliment Pharmacol Ther:索拉非尼的毒性可预测肝癌患者生存率改善

2017-05-11 石岩 环球医学

2017年4月,发表在《Aliment Pharmacol Ther》的一项多中心、前瞻性研究表明,索拉非尼的毒性能够预测肝细胞癌(HCC)患者生存率的改善。

2017年4月,发表在《Aliment Pharmacol Ther》的一项多中心、前瞻性研究表明,索拉非尼的毒性能够预测肝细胞癌(HCC)患者生存率的改善。

背景:HCC是全世界第六大最常见的癌症,即使治疗也有较高死亡率。尽管晚期HCC患者使用索拉非尼有生存获益,但临床应答非常多变。

目的:确定索拉非尼的毒性进展是否是HCC患者生存率的预后标志物。

方法:在本项前瞻性、多中心队列研究中,纳入来自5个国际专业中心的接受索拉非尼的晚期HCC患者。前瞻性地记录人口统计学和临床数据,包括治疗期间索拉非尼毒性的进展和等级,对索拉非尼的放射反应和患者的存活时间(以月为单位)。

结果:此研究总共招募634位接受索拉非尼的晚期HCC患者,6692.3人月风险的中位随访。多数患者是男性(81%),其中,Child-Pugh A期肝病占74%,巴塞罗那临床肝癌C期HCC占64%。中位生存期为8.1个月(IQR 3.8~18.6个月)。94%的患者经历至少一种索拉非尼相关毒性:34%腹泻,16%高血压,37%手足综合征(HFS)。21%的患者因毒性停服索拉非尼,59%的患者因疾病进展或死亡停止治疗。在多变量分析中,在校正年龄、肝病严重程度、肿瘤分期和索拉非尼剂量后,索拉非尼相关腹泻(HR 0.76,95% CI 0.61~0.95,P=0.017)、高血压(HR 0.531,95% CI 0.37~0.76,P<0.0001)和HFS(HR 0.65,95% CI 0.51~0.81,P<0.0001)都是总生存期的显着独立预测因素。

结论:索拉非尼相关毒性进展,包括腹泻、高血压和HFS,与接受索拉非尼治疗的晚期HCC患者总生存期延长相关。

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    2018-03-17 jj000001
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createdBy=3609256, createdName=zhu_jun9837, createdTime=Sat Dec 23 20:09:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787245, encodeId=e7371e8724501, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat Mar 17 08:09:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995978, encodeId=327619959e8fb, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, 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style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 03 17:09:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208102, encodeId=f05220810249, content=毒性反应来评价患者的生存时间,怎么听起来有点别扭, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7IIibwBWickvbvHticYfjyEn78iaUquKDQKRlgGIjc2iaxSPDk7HbZY0MxywvZibmbLER16zHg1Q8sgtmEeJLeO5iaHYt/0, createdBy=4b3d2070153, createdName=瘟神小子, createdTime=Thu Jun 08 09:28:09 CST 2017, time=2017-06-08, status=1, ipAttribution=), 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createdName=doctorJiangchao, createdTime=Mon May 15 06:50:10 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197692, encodeId=4e5519e692f5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Sat May 13 23:21:51 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-12-31 yb6560
  5. 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style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 03 17:09:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208102, encodeId=f05220810249, content=毒性反应来评价患者的生存时间,怎么听起来有点别扭, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7IIibwBWickvbvHticYfjyEn78iaUquKDQKRlgGIjc2iaxSPDk7HbZY0MxywvZibmbLER16zHg1Q8sgtmEeJLeO5iaHYt/0, createdBy=4b3d2070153, createdName=瘟神小子, createdTime=Thu Jun 08 09:28:09 CST 2017, time=2017-06-08, status=1, ipAttribution=), 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createdName=doctorJiangchao, createdTime=Mon May 15 06:50:10 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197692, encodeId=4e5519e692f5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Sat May 13 23:21:51 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
  6. 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style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 03 17:09:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208102, encodeId=f05220810249, content=毒性反应来评价患者的生存时间,怎么听起来有点别扭, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7IIibwBWickvbvHticYfjyEn78iaUquKDQKRlgGIjc2iaxSPDk7HbZY0MxywvZibmbLER16zHg1Q8sgtmEeJLeO5iaHYt/0, createdBy=4b3d2070153, createdName=瘟神小子, createdTime=Thu Jun 08 09:28:09 CST 2017, time=2017-06-08, status=1, ipAttribution=), 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  7. 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GetPortalCommentsPageByObjectIdResponse(id=203866, encodeId=3f4520386600, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon May 29 07:26:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198221, encodeId=f79119822183, content=继续学习。 , beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon May 15 06:50:10 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197692, encodeId=4e5519e692f5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Sat May 13 23:21:51 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-06-08 瘟神小子

    毒性反应来评价患者的生存时间,怎么听起来有点别扭

    0

  8. 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style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 03 17:09:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208102, encodeId=f05220810249, content=毒性反应来评价患者的生存时间,怎么听起来有点别扭, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7IIibwBWickvbvHticYfjyEn78iaUquKDQKRlgGIjc2iaxSPDk7HbZY0MxywvZibmbLER16zHg1Q8sgtmEeJLeO5iaHYt/0, createdBy=4b3d2070153, createdName=瘟神小子, createdTime=Thu Jun 08 09:28:09 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203866, encodeId=3f4520386600, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon May 29 07:26:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198221, encodeId=f79119822183, content=继续学习。 , beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon May 15 06:50:10 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197692, encodeId=4e5519e692f5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Sat May 13 23:21:51 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-05-29 laoli

    学习了,谢谢分享!

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1908251, encodeId=e7f219082517b, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Tue Nov 28 03:09:00 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1969003, encodeId=ba771969003c1, content=<a href='/topic/show?id=4dd7812e8f3' target=_blank style='color:#2F92EE;'>#肝癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81278, encryptionId=4dd7812e8f3, topicName=肝癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, 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style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 03 17:09:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208102, encodeId=f05220810249, content=毒性反应来评价患者的生存时间,怎么听起来有点别扭, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7IIibwBWickvbvHticYfjyEn78iaUquKDQKRlgGIjc2iaxSPDk7HbZY0MxywvZibmbLER16zHg1Q8sgtmEeJLeO5iaHYt/0, createdBy=4b3d2070153, createdName=瘟神小子, createdTime=Thu Jun 08 09:28:09 CST 2017, time=2017-06-08, status=1, ipAttribution=), 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createdName=doctorJiangchao, createdTime=Mon May 15 06:50:10 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197692, encodeId=4e5519e692f5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Sat May 13 23:21:51 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-05-15 doctorJiangchao

    继续学习。

    0

  10. 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style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Wed Jan 03 17:09:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=208102, encodeId=f05220810249, content=毒性反应来评价患者的生存时间,怎么听起来有点别扭, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7IIibwBWickvbvHticYfjyEn78iaUquKDQKRlgGIjc2iaxSPDk7HbZY0MxywvZibmbLER16zHg1Q8sgtmEeJLeO5iaHYt/0, createdBy=4b3d2070153, createdName=瘟神小子, createdTime=Thu Jun 08 09:28:09 CST 2017, time=2017-06-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=203866, encodeId=3f4520386600, content=学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Mon May 29 07:26:00 CST 2017, time=2017-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198221, encodeId=f79119822183, content=继续学习。 , beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Mon May 15 06:50:10 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197692, encodeId=4e5519e692f5, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=550d2008262, createdName=luominglian113, createdTime=Sat May 13 23:21:51 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-05-13 luominglian113

    学习了,谢谢分享

    0

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J Hepatol:β2肾上腺素能受体影响肝癌对索拉非尼耐药

近日国际著名肝脏疾病杂志Journal of Hepatology(最新影响因子11.665)在线发表了第二军医大学附属东方肝胆外科医院题为“ADRB2 Signaling Promotes HCC Progression and Sorafenib Resistance by Inhibiting Autophagic Degradation of HIF1α”的研究论文,证实了β2肾上腺素能受

Lancet Oncol:索拉非尼对肝癌术后患者疗效不佳

研究者进行了一项3期、双盲、安慰剂对照试验,探究术后或局部消融后肝细胞癌患者,进行辅助治疗时,索拉非尼的有效性和安全性。该研究在28个国家202个中心进行,纳入了术后(n=900)或局部消融(n=214) 后完成了放疗的肝细胞癌患者。研究对象随机分为实验组:口服400mg索拉非尼 bid,以及安慰剂对照组。最长的进行了4年。研究者根据研究对象的治疗、区域、Child-Pugh情况、复发风险等进行分

Thyroid:索拉非尼治疗晚期甲状腺髓样癌有效性和安全性评价

研究者进行了一项研究,评估索拉非尼治疗晚期甲状腺髓样癌 (MTC)的有效性和安全性。该回顾性队列研究纳入了2011-12至2015-1月间的13名进展性转移的MTC患者,服用索拉非尼400 mg 两次/天。以索拉非尼治疗下的疾病缓解情况和无进展生存(PFS)作为主要结局指标。因为开始索拉非尼治疗后1周,出现严重皮肤过敏反应而排出了1名患者。12名转移性MTC患者的研究数据显示,参与者中位数年龄48

Lancet Oncol:治疗急性髓细胞性白血病,索拉非尼已初见成效

来自非随机试验的临床前的数据和结果表明,多激酶抑制剂索拉非尼可能是一种有效的药物用于治疗急性髓细胞性白血病的治疗。研究人员调查了除了标准化疗,索拉非尼与安慰剂的疗效性和耐受性,参与者为年龄在60岁或以下的急性髓细胞性白血病患者。这项随机,双盲,安慰剂对照,2期临床试验已经在德国的25个站点完成。研究人员招募了年龄在18-60岁初诊,以前没有治疗过急性髓性白血病,且世界卫生组织临床性能得分0-2,有

Gastroenterol:一种驱虫药有望高效地治疗肝细胞癌

作为一种与肝病和肝硬化相关联的癌症,肝细胞癌(HCC)经常在晚期时才表现出症状。在全世界,它是癌症死亡的第二大原因,但是迄今为止,它并没有一种有效的疗法。 美国加州大学旧金山分校计算健康科学研究所主任Atul Butte博士说,正如没有治疗方法的其他疾病那样,需要理解和治疗这种癌