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固定剂量率吉西他滨治疗铂耐药卵巢癌的II期试验:一项西班牙卵巢癌研究小组(GEICO)试验

A phase II trial of fixed-dosed rate gemcitabine in platinum-resistant ovarian cancer: a GEICO (Grupo Español de Investigación en Cáncer de Ovario) Trial.

作者信息

Ojeda Gonzalez Belen, Gonzalez Martin Antonio, Bover Barcelo Isabel, Fabregat i Mayol Xavier, Mellado Begoña, Rubio Perez María Jesus, Alonso Carrion Lorenzo, Casado Herraez Antonio, Calvo Garcia Elisa, Churruca Galaz Cristina, Arcusa Lanza Angels, Herrero Ibañez Ana, Adrover Cebrian Encarna, Poveda Velasco Andres

机构信息

Oncology Department, Hospital de la Santa Creu i Sant Pau, C/Padre Claret 167, Barcelona, Spain.

出版信息

Am J Clin Oncol. 2008 Oct;31(5):481-7. doi: 10.1097/COC.0b013e31816d1c7b.

Abstract

OBJECTIVES

Gemcitabine has well-recognized activity in the treatment of ovarian cancer. Fixed-dose rate (FDR) delivery has been proposed as a more rationale way to administer gemcitabine, to avoid saturation of the enzyme that catalyzes its intracellular transformation into the active metabolites, difluorodeoxycitidine biphosphate, and triphosphate. Our aim was to assess clinical activity of gemcitabine delivered by FDR infusion in patients with platinum resistant ovarian cancer.

MATERIALS AND METHODS

Patients with platinum-resistant ovarian cancer received gemcitabine 1000 mg/m(2) over 120 minutes on days 1 and 8 of each cycle. Cycles were repeated every 3 weeks, and up to 6 cycles were delivered.

RESULTS

Forty-eight patients were included in the study. Among 41 patients evaluable for response, 9 clinical responses (1 complete response and 8 partial responses) were observed, achieving a global response rate of 22%. Grade 3 to 4 hematological toxicity consisted of anemia (15% of patients), neutropenia (24%), and thrombopenia (10%). One patient died due to septic shock. The main grade 3 to 4 nonhematological toxicity was asthenia (7 patients, 17%).

CONCLUSION

Activity of gemcitabine administered by FDR infusion in patients with platinum-resistant ovarian cancer seems similar to that achieved using 30-minute infusions, with higher toxicity.

摘要

目的

吉西他滨在卵巢癌治疗中的活性已得到广泛认可。固定剂量率(FDR)给药方式被认为是一种更合理的吉西他滨给药方式,可避免催化其细胞内转化为活性代谢产物二磷酸二氟脱氧胞苷和三磷酸二氟脱氧胞苷的酶饱和。我们的目的是评估FDR输注给予吉西他滨对铂耐药卵巢癌患者的临床活性。

材料与方法

铂耐药卵巢癌患者在每个周期的第1天和第8天,120分钟内接受1000mg/m²的吉西他滨。每3周重复一个周期,最多进行6个周期。

结果

48例患者纳入研究。在41例可评估反应的患者中,观察到9例临床反应(1例完全缓解和8例部分缓解),总缓解率为22%。3至4级血液学毒性包括贫血(15%的患者)、中性粒细胞减少(24%)和血小板减少(10%)。1例患者死于感染性休克。主要的3至4级非血液学毒性是乏力(7例患者,17%)。

结论

FDR输注给予吉西他滨对铂耐药卵巢癌患者的活性似乎与30分钟输注相似,但毒性更高。

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