Schmid P, Kühnhardt D, Kiewe P, Lehenbauer-Dehm S, Schippinger W, Greil R, Lange W, Preiss J, Niederle N, Brossart P, Freier W, Kümmel S, Van de Velde H, Regierer A, Possinger K
Medical Oncology, Imperial College London, Charing Cross Hospital, London, UK.
Ann Oncol. 2008 May;19(5):871-6. doi: 10.1093/annonc/mdm569. Epub 2008 Jan 21.
Proteasome inhibitors are a novel class of compounds entering clinical trials as a method to increase tumour sensitivity to standard chemotherapy. This phase I/II trial was carried out to evaluate the combination of capecitabine and the proteasome inhibitor bortezomib in anthracycline and/or taxane-pretreated patients with metastatic breast cancer.
A total of 35 patients were treated with bortezomib (1.0-1.3 mg/m(2) on days 1, 4, 8 and 11) and capecitabine (1500-2500 mg/m(2) on days 1-14) in 3-week intervals for up to eight cycles.
The maximum tolerated doses (MTDs) were bortezomib 1.3 mg/m(2) and capecitabine 2500 mg/m(2). The treatment was generally well tolerated and associated with toxic effects that were consistent with the known side-effects of the individual agents. The intent-to-treat overall response rate was 15% and an additional 27% of patients had stable disease (SD). In the 20 patients treated at the MTD, the response rate was 15% and 40% had SD. Median time to progression and overall survival were 3.5 months [95% confidence interval (CI) 1.9-4.4] and 7.5 months (95% CI 5.6-14.6), respectively. Median duration of response was 4.4 months.
The combination of bortezomib and capecitabine is well tolerated and has moderate antitumour activity in heavily pretreated patients.
蛋白酶体抑制剂是一类新型化合物,正进入临床试验,作为一种提高肿瘤对标准化疗敏感性的方法。开展这项I/II期试验以评估卡培他滨与蛋白酶体抑制剂硼替佐米联合用于蒽环类药物和/或紫杉烷预处理的转移性乳腺癌患者的疗效。
共有35例患者接受硼替佐米(第1、4、8和11天1.0 - 1.3mg/m²)和卡培他滨(第1 - 14天1500 - 2500mg/m²)治疗,每3周为一个周期,最多进行8个周期。
最大耐受剂量(MTD)为硼替佐米1.3mg/m²和卡培他滨2500mg/m²。治疗总体耐受性良好,且毒性反应与各药物已知的副作用一致。意向性治疗的总缓解率为15%,另有27%的患者疾病稳定(SD)。在接受MTD治疗的20例患者中,缓解率为15%,40%的患者疾病稳定。中位进展时间和总生存期分别为3.5个月[95%置信区间(CI)1.9 - 4.4]和7.5个月(95%CI 5.6 - 14.6)。中位缓解持续时间为4.4个月。
硼替佐米和卡培他滨联合用药耐受性良好,在经过大量预处理的患者中具有适度的抗肿瘤活性。