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卡铂联合聚乙二醇化脂质体阿霉素作为晚期或复发性子宫内膜癌患者一线化疗的多中心II期研究:MITO(意大利卵巢癌和妇科恶性肿瘤多中心试验)组的END-1研究

A multicentre phase II study of carboplatin plus pegylated liposomal doxorubicin as first-line chemotherapy for patients with advanced or recurrent endometrial carcinoma: the END-1 study of the MITO (Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies) group.

作者信息

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

机构信息

Instituto Nazionale Tumori, UOC Oncologia Medica B, Napoli, Italy.

出版信息

Br J Cancer. 2007 Jun 4;96(11):1639-43. doi: 10.1038/sj.bjc.6603787. Epub 2007 May 8.

Abstract

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.

摘要

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。

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