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一项关于口服尿嘧啶/替加氟(UFT)联合亚叶酸钙并与奥沙利铂联合使用(TEGAFOX)作为转移性结直肠癌患者一线治疗的II期研究

'A phase II study of oral uracil/ftorafur (UFT) plus leucovorin combined with oxaliplatin (TEGAFOX) as first-line treatment in patients with metastatic colorectal cancer'.

作者信息

Bennouna J, Perrier H, Paillot B, Priou F, Jacob J H, Hebbar M, Bordenave S, Seitz J F, Cvitkovic F, Dorval E, Malek K, Tonelli D, Douillard J Y

机构信息

Centre René Gauducheau, Nantes, France.

出版信息

Br J Cancer. 2006 Jan 16;94(1):69-73. doi: 10.1038/sj.bjc.6602913.

Abstract

This phase II trial was performed to evaluate the efficacy and tolerability of a new combination of Uracil/Ftorafur (UFT)/leucovorin (LV) and oxaliplatin in patients (pts) with metastatic colorectal cancer (MCRC) who had not received prior chemotherapy for metastatic disease. Between February 2002 and October 2002, 64 patients received UFT 300 mg m(-2) day(-1) and LV 90 mg day(-1) from day 1 to day 14 combined with oxaliplatin 130 mg m(-2) on day 1, every 3 weeks. All patients were evaluable for safety analysis and 58 of 64 patients were eligible for efficacy. Responses were reviewed by an independent review committee. Of the 58 per-protocol defined assessable patients, 1 complete response and 20 partial responses were observed yielding a response rate of 34% (95% CI: 22-47). The median response duration was 8.74 months (range 1.6-14). The median time to progression and the median survival were 5.88 months (95% CI: 4.34-8.21) and 18.2 months (95% CI: 10-20.7), respectively. Diarrhoea and peripheral neuropathy were the most frequent and predictable toxicities. These events were reversible, noncumulative and manageable. Grade 3 diarrhoea occurred in only 11% of the patients. No grade 4 gastrointestinal toxicity was reported in the study. The incidence of grade 3/4 (National Cancer Institute Common Toxicity Criteria 2: NCI-CTC 2) peripheral neuropathy was 15%. Haematological toxicity was of mild to moderate intensity with 10% of the patients with Grade 3/4 neutropenia without any episode of complication. The TEGAFOX regimen, a new combination using UFT/LV and oxaliplatin every 3 weeks is feasible on an outpatient basis. The combination is safe and active and may offer a promising alternative to the intravenous route. Nevertheless this efficacy results should be confirmed by randomized phase III trials.

摘要

本II期试验旨在评估尿嘧啶/替加氟(UFT)/亚叶酸(LV)与奥沙利铂的新联合方案对未接受过转移性疾病化疗的转移性结直肠癌(MCRC)患者的疗效和耐受性。在2002年2月至2002年10月期间,64例患者从第1天至第14天接受UFT 300 mg m⁻² 天⁻¹和LV 90 mg天⁻¹,并在第1天联合奥沙利铂130 mg m⁻²,每3周重复一次。所有患者均纳入安全性分析,64例患者中有58例符合疗效评估标准。疗效由独立审查委员会评估。在58例符合方案定义的可评估患者中,观察到1例完全缓解和20例部分缓解,缓解率为34%(95%CI:22 - 47)。中位缓解持续时间为8.74个月(范围1.6 - 14个月)。中位疾病进展时间和中位生存期分别为5.88个月(95%CI:4.34 - 8.21)和18.2个月(95%CI:10 - 20.7)。腹泻和周围神经病变是最常见且可预测的毒性反应。这些事件是可逆的、非累积性的且易于管理。3级腹泻仅发生在11%的患者中。研究中未报告4级胃肠道毒性。3/4级(美国国立癌症研究所常见毒性标准2:NCI - CTC 2)周围神经病变的发生率为15%。血液学毒性为轻度至中度,10%的患者出现3/4级中性粒细胞减少,无任何并发症发生。TEGAFOX方案,即每3周使用UFT/LV和奥沙利铂的新联合方案,在门诊实施是可行的。该联合方案安全且有效,可能为静脉给药途径提供有前景的替代方案。然而,这一疗效结果应通过随机III期试验予以证实。

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