Hecht J Randolph, Patnaik Amita, Berlin Jordan, Venook Alan, Malik Imtiaz, Tchekmedyian Simon, Navale Lynn, Amado Rafael G, Meropol Neal J
University of California School of Medicine, Los Angeles, CA, USA.
Cancer. 2007 Sep 1;110(5):980-8. doi: 10.1002/cncr.22915.
The safety and efficacy of the fully human antibody panitumumab was evaluated in patients with metastatic colorectal cancer refractory to available therapies.
This phase 2 open-label, multicenter study of panitumumab enrolled patients with metastatic colorectal cancer who had progressed on chemotherapy that included a fluoropyrimidine and irinotecan or oxaliplatin, or both. All patients had tumors with > or =10% 1+ epidermal growth factor receptor (EGFr) staining by immunohistochemistry. Patients were stratified into 2 strata (high or low staining intensity) and received intravenous panitumumab 2.5 mg/kg weekly 8 of every 9 weeks until disease progression or unacceptable toxicity.
In all, 148 patients received panitumumab, 105 in the high EGFr stratum, 43 in the low EGFr stratum. Overall response by central review was 9% (95% confidence interval [CI], 5%-15%) and was similar between strata. An additional 29% of patients had stable disease. Median progression-free survival was 14 weeks (95% CI, 8-16) and median overall survival was 9 months (95% CI, 6-10). Toxicities were manageable, with skin toxicity reported in 95% of patients (5% grade 3 or 4). Four patients discontinued therapy because of toxicity. No antipanitumumab antibodies were detected. One patient had an infusion reaction but was able to continue therapy.
Panitumumab given weekly was well tolerated and had single-agent activity in previously treated patients with colorectal cancer. Dermatologic toxicity was common but rarely severe. Ongoing studies will determine panitumumab activity earlier in the course of treatment for colorectal cancer and in combination with other antineoplastic agents.
在对现有疗法难治的转移性结直肠癌患者中评估了全人源抗体帕尼单抗的安全性和有效性。
这项帕尼单抗的2期开放标签、多中心研究纳入了在含氟嘧啶和伊立替康或奥沙利铂或两者的化疗中病情进展的转移性结直肠癌患者。所有患者的肿瘤通过免疫组织化学检测显示表皮生长因子受体(EGFr)染色≥10%(1+)。患者被分为2个分层(高或低染色强度),每9周中的8周接受静脉注射帕尼单抗2.5mg/kg,直至疾病进展或出现不可接受的毒性。
共有148例患者接受了帕尼单抗治疗,其中105例在高EGFr分层,43例在低EGFr分层。经中心评估的总体缓解率为9%(95%置信区间[CI],5%-15%),各分层之间相似。另外29%的患者病情稳定。中位无进展生存期为14周(95%CI,8-16),中位总生存期为9个月(95%CI,6-10)。毒性反应可控,95%的患者报告有皮肤毒性(5%为3级或4级)。4例患者因毒性反应停止治疗。未检测到抗帕尼单抗抗体。1例患者出现输液反应,但能够继续治疗。
每周给予帕尼单抗耐受性良好,对先前治疗过的结直肠癌患者具有单药活性。皮肤毒性常见但很少严重。正在进行的研究将确定帕尼单抗在结直肠癌治疗过程中更早阶段以及与其他抗肿瘤药物联合使用时的活性。