Sørensen P, Høyer M, Jakobsen A, Malmström H, Havsteen H, Bertelsen K
Department of Oncology, Odense University Hospital, DK-5000 Odense C, Denmark.
Gynecol Oncol. 2001 Apr;81(1):58-62. doi: 10.1006/gyno.2000.6089.
The purpose of this phase II study was to evaluate on an intent-to-treat basis the activity and toxicity of single-agent vinorelbine (VRL) as second-line chemotherapy of patients with platinum-resistant ovarian cancer. Platinum-resistant disease was defined as disease refractory to or relapsing within 12 months after finishing platinum-containing chemotherapy.
VRL (30 mg/m(2)) was administered intravenously as a bolus injection days 1 and 8 every 21 days. Initially, four courses of VRL were given. Patients with responding or stable disease received four more courses of VRL to a maximum of eight courses.
Twenty-eight of 33 eligible patients were considered evaluable for response. The overall response rate was 21% (7/33) (95% CI: 7--35). Median time to progression was 3.1 months and median survival was 10.1 months. Toxicity was generally mild. Leukopenia was the dose-limiting toxicity. CALGB grade III/IV infection was observed in 15/0% of patients. The most important nonhematologic toxicities were nausea and constipation. Grade III/IV nausea was observed in 6/0% and grade III/IV constipation in 3/3% of patients. Peripheral neurotoxicity was only a minor problem with no grade III/IV toxicity. No patients stopped treatment because of toxicity and no toxic death was reported.
VRL was generally well tolerated, but the activity in platinum-resistant ovarian cancer was only modest, although fully comparable to other second-line treatments. Further studies are required to define the role of VRL in combination chemotherapy for ovarian cancer.
本II期研究旨在基于意向性治疗评估单药长春瑞滨(VRL)作为铂耐药卵巢癌患者二线化疗的活性和毒性。铂耐药疾病定义为对含铂化疗难治或在完成含铂化疗后12个月内复发的疾病。
VRL(30mg/m²)于第1天和第8天静脉推注给药,每21天为一周期。最初给予四个周期的VRL。疾病缓解或稳定的患者再接受四个周期的VRL,最多八个周期。
33例符合条件的患者中有28例被认为可评估疗效。总缓解率为21%(7/33)(95%CI:7%-35%)。中位疾病进展时间为3.1个月,中位生存期为10.1个月。毒性一般较轻。白细胞减少是剂量限制性毒性。15/0%的患者观察到CALGB III/IV级感染。最重要的非血液学毒性是恶心和便秘。6/0%的患者观察到III/IV级恶心,3/3%的患者观察到III/IV级便秘。周围神经毒性只是一个小问题,无III/IV级毒性。没有患者因毒性而停止治疗,也未报告有因毒性导致的死亡。
VRL总体耐受性良好,但在铂耐药卵巢癌中的活性仅为中等,尽管与其他二线治疗完全相当。需要进一步研究来确定VRL在卵巢癌联合化疗中的作用。