Penel Nicolas, Bui Binh Nguyen, Bay Jacques-Olivier, Cupissol Didier, Ray-Coquard Isabelle, Piperno-Neumann Sophie, Kerbrat Pierre, Fournier Charles, Taieb Sophie, Jimenez Marta, Isambert Nicolas, Peyrade Frédéric, Chevreau Christine, Bompas Emmanuelle, Brain Etienne G C, Blay Jean-Yves
Département de Cancérologie Générale, Centre Oscar Lambret, Lille, France.
J Clin Oncol. 2008 Nov 10;26(32):5269-74. doi: 10.1200/JCO.2008.17.3146. Epub 2008 Sep 22.
The objective of this phase II trial was to assess the efficacy and toxicity of weekly paclitaxel for patients with metastatic or unresectable angiosarcoma.
Thirty patients were entered onto the study from April 2005 through October 2006. Paclitaxel was administered intravenously as a 60-minute infusion at a dose of 80 mg/m(2) on days 1, 8, and 15 of a 4-week cycle. The primary end point was the nonprogression rate after two cycles.
The progression-free survival rates after 2 and 4 months were 74% and 45%, respectively. With a median follow-up of 8 months, the median time to progression was 4 months and the median overall survival was 8 months. The progression-free survival rate was similar in patients pretreated with chemotherapy and in chemotherapy-naïve patients (77% v 71%). Three patients with locally advanced breast angiosarcoma presented partial response, which enabled a secondary curative-intent surgery with complete histologic response in two cases. One toxic death occurred as a result of a thrombocytopenia episode. Six patients presented with grade 3 toxicities and one patient presented with a grade 4 toxicity. Anemia and fatigue were the most frequently reported toxicities.
Weekly paclitaxel at the dose schedule used in the current study was well tolerated and demonstrated clinical benefit.
本II期试验的目的是评估每周使用紫杉醇治疗转移性或不可切除血管肉瘤患者的疗效和毒性。
2005年4月至2006年10月期间,30名患者进入本研究。紫杉醇以80mg/m²的剂量在4周周期的第1、8和15天静脉输注60分钟。主要终点是两个周期后的无进展率。
2个月和4个月后的无进展生存率分别为74%和45%。中位随访8个月,中位进展时间为4个月,中位总生存期为8个月。接受过化疗的患者和未接受过化疗的患者的无进展生存率相似(77%对71%)。3例局部晚期乳腺血管肉瘤患者出现部分缓解,其中2例患者因此接受了具有治愈意图的二次手术,术后组织学完全缓解。1例患者因血小板减少症发作导致毒性死亡。6例患者出现3级毒性,1例患者出现4级毒性。贫血和疲劳是最常报告的毒性反应。
本研究中使用的紫杉醇每周给药方案耐受性良好,并显示出临床获益。