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每周一次长春瑞滨治疗复发性恶性胸膜间皮瘤的疗效与安全性。

The efficacy and safety of weekly vinorelbine in relapsed malignant pleural mesothelioma.

作者信息

Stebbing Justin, Powles Thomas, McPherson Kirsty, Shamash Jonathan, Wells Paula, Sheaff Michael T, Slater Sarah, Rudd Robin M, Fennell Dean, Steele Jeremy P C

机构信息

Department of Medical Oncology, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.

出版信息

Lung Cancer. 2009 Jan;63(1):94-7. doi: 10.1016/j.lungcan.2008.04.001. Epub 2008 May 16.

Abstract

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.

摘要

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。

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