国家药监局批准卫材仑伐替尼治疗甲状腺癌,这是第二个适应症

2020-11-09 MedSci原创 MedSci原创

在中国,每年约有19万例新诊断的甲状腺癌患者,每年大约有8600例死亡。据中国肿瘤登记中心的数据,中国甲状腺癌将以每年20%的速度持续增长。发表在《柳叶刀-糖尿病和内分泌学》的一篇文献报道指出,甲状腺

在中国,每年约有19万例新诊断的甲状腺癌患者,每年大约有8600例死亡。据中国肿瘤登记中心的数据,中国甲状腺癌将以每年20%的速度持续增长。甲状腺癌在中年女性(35-64岁)中的发病率较高。根据组织学特征,甲状腺癌可分为DTC和未分化型甲状腺癌(ATC),DTC占全部甲状腺癌的90%以上,早期患者预后好,包括较常见的甲状腺乳头状癌和甲状腺滤泡状癌。其仍然是一种医疗需求未得到充分满足的疾病。

11月9日,根据中国国家药品监督管理局(NMPA)药品批件发布通知显示,卫材(Eisai)的仑伐替尼获得新的批准文号。去年12月,该药拟用于治疗分化型甲状腺癌(DTC)患者的上市申请(JXHS1900157 / JXHS1900158)获药品审评中心(CDE)受理。

仑伐替尼新适应症的上市申请主要基于一项全球范围内针对放射性碘难治性分化型甲状腺癌患者开展的SELECT研究(303研究)的成果。

2015年,美国FDA和欧洲药品管理局EMA批准仑伐替尼用于治疗侵袭性、局部晚期或转移性分化型甲状腺癌

2018年,FDA批准仑伐替尼用于放射性碘难治性分化型甲状腺癌的适应症。在该项临床试验中,对放射性碘难治性分化型甲状腺癌(RR-DTC)的定义包括:经所有放射性碘扫描均显示不存在碘摄入的一个或多个可测量病变——病灶不摄入碘;一个或多个可测量病变在放射性碘 131 治疗 12个月内出现进展,尽管治疗前或治疗后扫描显示出放射性碘亲和力——摄入碘但无效;入组前末次给药距离研究入组至少 6 个月,放射性碘 131 的累积活性>600 mCi 或 22 GBq——碘累积量已过高。如果患者符合包括上述RR-DTC定义在内的入组条件,或许可以参加仑伐替尼在中国进行的临床试验。

在全球的SELECT研究中,主要终点是无进展生存期(PFS),本研究共纳入 392 例(51% 为男性,平均年龄 63.0 岁)患者。最终结果显示,治疗组的 PFS 明显高于对照组(18.3 个月 vs 3.6 个月),风险比为 0.21,其中,既往未接受过 VEGFR 靶向治疗的患者(195 例)比接受过(66 例)的 PFS 更长(18.7 个月 vs15.1 个月)。另外,治疗组的完全缓解率、部分缓解率和中位暴露时间分别为 1.5%(4 例)、63.2%(165 例)和 13.8 个月;而对照组分别为 0、1.5%(2 例)和 3.9 个月。治疗组的中位响应时间为 2 个月。

在中国的一项仑伐替尼在放射性碘难治性分化型甲状腺癌中的疗效的3期308研究结果待卫材公布。

关于仑伐替尼

仑伐替尼是一种多靶点酪氨酸激酶抑制剂,可以阻滞肿瘤细胞内包括VEGFR1-3、FGFR1-4、PDGFRα、KIT、RET在内的一系列靶点。2015年2月,该药获美国FDA批准用于治疗局部复发或转移性、进行性、放射性碘难治性分化型甲状腺癌,后又获批治疗肾细胞癌、肝癌和子宫内膜癌;2018年9月,仑伐替尼正式在中国获批,用于治疗既往未接受过全身系统治疗的不可切除的肝细胞癌。

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    2020-11-11 xuyu
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    2020-11-09 lovetcm

    #仑伐替尼#治疗#甲状腺癌#,其它的如#安罗替尼#也激烈竞争

    0

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