Pignata S, Scambia G, Pisano C, Breda E, Di Maio M, Greggi S, Ferrandina G, Lorusso D, Zagonel V, Febbraro A, Riva N, De Rosa V, Gallo C, Perrone F
Instituto Nazionale Tumori, UOC Oncologia Medica B, Napoli, Italy.
Br J Cancer. 2007 Jun 4;96(11):1639-43. doi: 10.1038/sj.bjc.6603787. Epub 2007 May 8.
Anthracyclines and platinum derivates are active drugs for advanced endometrial carcinoma (AEC), but new schedules with higher efficacy and better tolerability are needed. A phase II study was conducted to describe activity and tolerability of carboplatin (C)+pegylated liposomal doxorubicin (PLD) in patients with AEC. Patients with chemonaive AEC, PS < or = 2, aged < 75 years, with at least one measurable lesion were eligible. Treatment was C (area under curve 5)+PLD (40 mg m(-2)) on day 1 every 4 weeks, up to six cycles. Forty-two patients were needed in a single-stage design, with at least 13 objective responses to define the treatment active. Forty-two patients were enrolled. Median age was 64 years (31-74). A total of 64% of patients were recurrent while 36% were advanced. Three complete (7%) and 22 partial responses (52%) were observed, for an overall response rate of 59.5% (95% exact CI: 43.3-74.3). One death potentially related to treatment was recorded (death at home for unknown reasons after 6th cycle). Other relevant toxicities (% of patients) were grade 3/4 neutropaenia 33%/14%, febrile neutropaenia 5%, grade 3/4 thrombocytopaenia 17%/5%, grade 3/4 anaemia 31%/2%. Skin toxicity was mild: grade 1 14%, grade 2 10%, grade 3 5%. Hair loss: complete 5%, partial 12%. The combination of carboplatin and PLD shows good activity and favourable toxicity as first-line chemotherapy of patients with AEC, deserving further studies in this setting.
蒽环类药物和铂类衍生物是晚期子宫内膜癌(AEC)的有效药物,但需要疗效更高、耐受性更好的新方案。开展了一项II期研究,以描述卡铂(C)+聚乙二醇化脂质体阿霉素(PLD)治疗AEC患者的活性和耐受性。符合条件的患者为初治AEC患者,体能状态(PS)≤2,年龄<75岁,至少有一处可测量病灶。治疗方案为每4周的第1天给予C(曲线下面积为5)+PLD(40mg/m²),最多6个周期。单阶段设计需要42例患者,至少13例客观缓解才能确定治疗有效。共入组42例患者。中位年龄为64岁(31 - 74岁)。64%的患者为复发型,36%为晚期。观察到3例完全缓解(7%)和22例部分缓解(52%),总缓解率为59.5%(95%确切可信区间:43.3 - 74.3)。记录到1例可能与治疗相关的死亡(第6周期后在家中不明原因死亡)。其他相关毒性(患者百分比)为3/4级中性粒细胞减少33%/14%,发热性中性粒细胞减少5%,3/4级血小板减少17%/5%,3/4级贫血31%/2%。皮肤毒性较轻:1级14%,2级10%,3级5%。脱发:完全脱发5%,部分脱发12%。卡铂和PLD联合作为AEC患者的一线化疗显示出良好的活性和良好的毒性,值得在此背景下进一步研究。