Lilenbaum Rogerio, Raez Luis, Tseng Jennifer, Seigel Leonard, Davila Enrique
The Mount Sinai CCOP, Miami Beach, Florida 33140, USA.
J Thorac Oncol. 2008 May;3(5):511-5. doi: 10.1097/JTO.0b013e31816de28f.
We conducted a multicenter phase II study to evaluate the efficacy and safety of oxaliplatin and gemcitabine with bevacizumab in patients with advanced non-small cell lung cancer (NSCLC).
Patients with chemotherapy-naive, nonsquamous, stage IIIB or IV NSCLC received gemcitabine 1000 mg/m on days 1 and 8, oxaliplatin 130 mg/m on day 1, and bevacizumab 15 mg/kg on day 1 every 21 days for 4 cycles. Patients with stable disease or response received maintenance bevacizumab every 3 weeks until progression. Primary end point was median time to progression (TTP).
Nineteen of 44 eligible patients had partial response in the intent-to-treat analysis for an objective response rate of 43% (95% confidence interval [CI], 26.3-60.1%); 16 patients had stable disease for a disease control rate of 80% (95% CI, 72.0-87.0%). Median TTP was 5.5 months (95% CI, 3.8-6.9 months), which approached that seen in phase III studies. Median survival was 13.7 months (95% CI, 7.3-21.8 months). The most common grade 3 or 4 adverse events were hypertension (11%), neutropenia (9%), diarrhea (7%), dyspnea (7%), and thromboembolic events (7%). Pulmonary hemorrhage was not observed.
The results of this phase II study suggest that oxaliplatin and gemcitabine with bevacizumab was active and reasonably well tolerated. Median TTP approached that in phase III studies. This combination represents another treatment option for advanced NSCLC.
我们开展了一项多中心II期研究,以评估奥沙利铂、吉西他滨联合贝伐单抗治疗晚期非小细胞肺癌(NSCLC)患者的疗效和安全性。
既往未接受过化疗的非鳞状IIIB期或IV期NSCLC患者,每21天为一个周期,第1天和第8天接受吉西他滨1000mg/m²,第1天接受奥沙利铂130mg/m²,第1天接受贝伐单抗15mg/kg,共4个周期。病情稳定或有反应的患者每3周接受一次贝伐单抗维持治疗,直至病情进展。主要终点为中位疾病进展时间(TTP)。
在44例符合条件的患者中,19例在意向性分析中获得部分缓解,客观缓解率为43%(95%置信区间[CI],26.3-60.1%);16例患者病情稳定,疾病控制率为80%(95%CI,72.0-87.0%)。中位TTP为5.5个月(95%CI,3.8-6.9个月),接近III期研究中的结果。中位生存期为13.7个月(95%CI,7.3-21.8个月)。最常见的3级或4级不良事件为高血压(11%)、中性粒细胞减少(9%)、腹泻(7%)、呼吸困难(7%)和血栓栓塞事件(7%)。未观察到肺出血。
这项II期研究的结果表明,奥沙利铂、吉西他滨联合贝伐单抗具有活性且耐受性良好。中位TTP接近III期研究中的结果。这种联合方案是晚期NSCLC的另一种治疗选择。