Whitehead Robert P, McCoy Sheryl, Macdonald John S, Rivkin Saul E, Neubauer Marcus A, Dakhil Shaker R, Lenz Heinz-Josef, Tanaka Michael S, Abbruzzese James L
Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Invest New Drugs. 2006 Jul;24(4):335-41. doi: 10.1007/s10637-005-4345-3.
The purpose of this Phase II multi-institutional trial was to determine the efficacy and toxicity of R115777 in previously untreated patients with metastatic colorectal carcinoma.
Patients were required to have histologically confirmed colorectal cancer with distant metastatic disease that was not surgically curable. They could not have received prior chemotherapy for metastatic disease. R115777 was given at a dose of 300 mg p.o. twice a day for 21 days every 28 days until tumor progression or toxicity or other reason for discontinuation occurred. The primary endpoint was to determine the confirmed response probability with this treatment.
There were 55 eligible patients accrued to the study. There were no complete responses, but one confirmed partial response for a confirmed response probability of 2% (95%CI 0-10%). Three additional patients had an unconfirmed partial response for an overall response probability of 7%. The time to treatment failure was 1.7 months and the estimated median survival was 8.1 months. One patient died of treatment related infection and there were 7 other patients with grade 4 toxicities consisting of neutropenia, leukopenia, febrile neutropenia and thrombocytopenia, depression, increased bilirubin, anemia, and pneumonitis/infiltrates.
R115777 given as a single agent by this dose and schedule is ineffective in patients with metastatic colorectal cancer.
本II期多机构试验的目的是确定R115777对先前未接受过治疗的转移性结直肠癌患者的疗效和毒性。
患者需经组织学确诊为结直肠癌且伴有无法通过手术治愈的远处转移性疾病。他们不能曾接受过针对转移性疾病的化疗。R115777的给药剂量为口服300毫克,每天两次,每28天给药21天,直至出现肿瘤进展、毒性反应或其他停药原因。主要终点是确定该治疗方案的确认缓解概率。
共有55名符合条件的患者入组该研究。没有完全缓解的病例,但有1例确认的部分缓解,确认缓解概率为2%(95%置信区间0-10%)。另外3例患者有未经确认的部分缓解,总缓解概率为7%。治疗失败时间为1.7个月,估计中位生存期为8.1个月。1例患者死于与治疗相关的感染,另有7例患者出现4级毒性反应,包括中性粒细胞减少、白细胞减少、发热性中性粒细胞减少和血小板减少、抑郁、胆红素升高、贫血以及肺炎/浸润。
按照此剂量和给药方案单独使用R115777对转移性结直肠癌患者无效。