Stebbing Justin, Powles Thomas, McPherson Kirsty, Shamash Jonathan, Wells Paula, Sheaff Michael T, Slater Sarah, Rudd Robin M, Fennell Dean, Steele Jeremy P C
Department of Medical Oncology, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
Lung Cancer. 2009 Jan;63(1):94-7. doi: 10.1016/j.lungcan.2008.04.001. Epub 2008 May 16.
Malignant pleural mesothelioma (MPM) is a rapidly progressive invariably lethal tumor. Treatment options remain limited and the outcome in relapsed disease is poor warranting new therapeutic options. Following our previous experience in the first-line setting, we conducted a phase 2 open-label non-comparative study to assess the safety and efficacy of weekly vinorelbine chemotherapy, each cycle consisting of 30 mg/m(2) for 6 weeks, in patients with previous exposure to chemotherapy. In 63 individuals with relapsed MPM who had not received previous vinorelbine, we observed an objective response rate of 16% and an overall survival of 9.6 months (95% confidence interval 7.3-11.8 months). The main grade III/IV toxicity observed was neutropenia and toxicity was similar to weekly vinorelbine when used in the first-line setting. Weekly vinorelbine appeared to have a reasonable response rate with an acceptable toxicity profile in the second-line treatment of MPM. Its use should be prospectively evaluated in a randomised trial in the first or second-line therapy of MPM.
恶性胸膜间皮瘤(MPM)是一种进展迅速且几乎总是致命的肿瘤。治疗选择仍然有限,复发疾病的治疗效果不佳,因此需要新的治疗方案。基于我们之前在一线治疗中的经验,我们开展了一项2期开放标签非对照研究,以评估每周使用长春瑞滨化疗的安全性和疗效,每个周期为6周,剂量为30mg/m²,用于既往接受过化疗的患者。在63例既往未接受过长春瑞滨治疗的复发MPM患者中,我们观察到客观缓解率为16%,总生存期为9.6个月(95%置信区间7.3 - 11.8个月)。观察到的主要Ⅲ/Ⅳ级毒性为中性粒细胞减少,且毒性与一线治疗中使用长春瑞滨时相似。在MPM的二线治疗中,每周使用长春瑞滨似乎具有合理的缓解率和可接受的毒性特征。应在MPM一线或二线治疗的随机试验中对其使用进行前瞻性评估。