Muggia Franco M, Blessing John A, Method Michael, Miller David Scott, Johnson Gary A, Lee Roger B, Menzin Andrew
Division of Medical Oncology, Department of Medicine, Kaplan Cancer Center, New York University Medical Center, New York, NY 10016, USA.
Gynecol Oncol. 2004 Feb;92(2):639-43. doi: 10.1016/j.ygyno.2003.10.045.
Vinorelbine is being explored by the Gynecologic Oncology Group (GOG) for its possible use in advanced or recurrent squamous cell carcinoma of the uterine cervix. The objective of this Phase II trial was to evaluate a days 1 and 8 every-21-days schedule and determine its activity in patients who had failed standard chemotherapy.
Eligible patients with measurable disease and satisfactory baseline bone marrow, liver, and kidney functions were treated with vinorelbine 30 mg/m(2) given on days 1 and 8 every 21 days. A two-stage sampling design was used, proceeding to a second stage accrual if sufficient activity was documented in the first 25 patients.
The study did proceed to the second stage and accrued 44 patients. There were six objective responses (one complete, five partial) for a response rate of 13.7% (95% confidence interval: 5.2-27.4%). There were three patients with response in extra-pelvic sites (including the complete response) and three with response in the pelvis. The overall frequency of grades 3 and 4 neutropenia was 41%, whereas neuropathy was reported in 27% and was severe in three. Treatment-related pain, very severe in two instances, was also reported in 27%.
Vinorelbine has moderate activity in a pretreated population with squamous cell carcinoma of the cervix. Accordingly, vinorelbine in this days 1 and 8 schedule is being studied further in combination with cisplatin by the GOG.
妇科肿瘤学组(GOG)正在探索长春瑞滨在晚期或复发性子宫颈鳞状细胞癌中的可能用途。该II期试验的目的是评估每21天第1天和第8天给药方案,并确定其在标准化疗失败患者中的活性。
符合条件的可测量疾病患者以及基线骨髓、肝脏和肾脏功能良好的患者,接受长春瑞滨30mg/m²,每21天第1天和第8天给药。采用两阶段抽样设计,如果在前25名患者中记录到足够的活性,则进入第二阶段入组。
该研究确实进入了第二阶段,共入组44例患者。有6例客观缓解(1例完全缓解,5例部分缓解),缓解率为13.7%(95%置信区间:5.2 - 27.4%)。有3例患者在盆腔外部位有反应(包括1例完全缓解),3例在盆腔内有反应。3/4级中性粒细胞减少的总体发生率为41%,而27%的患者报告有神经病变,其中3例严重。27%的患者还报告有与治疗相关的疼痛,其中2例非常严重。
长春瑞滨在经预处理的子宫颈鳞状细胞癌患者中具有中等活性。因此,GOG正在进一步研究长春瑞滨在第1天和第8天给药方案与顺铂联合使用的情况。