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西妥昔单抗联合多西他赛用于晚期非小细胞肺癌化疗难治性/耐药患者的2期研究。

A phase 2 study of cetuximab in combination with docetaxel in chemotherapy-refractory/resistant patients with advanced nonsmall cell lung cancer.

作者信息

Kim Edward S, Mauer Ann M, William William N, Tran Hai T, Liu Diane, Lee Jack J, Windt Paul, Hong Waun K, Vokes Everett E, Herbst Roy S

机构信息

Department of Thoracic/Head & Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.

出版信息

Cancer. 2009 Apr 15;115(8):1713-22. doi: 10.1002/cncr.24148.

Abstract

BACKGROUND

Cetuximab in combination with docetaxel was examined in chemotherapy-refractory/resistant patients with advanced nonsmall-cell lung cancer (NSCLC) to determine response rate, survival, safety, and pharmacokinetics (PK).

METHODS

Patients had evidence of epidermal growth factor receptor (EGFR) expression (> or =1 +) and tumor progression during or disease recurrence within 3 months after chemotherapy. Cetuximab was administered weekly (400 mg/m(2) initial; 250 mg/m(2) thereafter). Docetaxel was administered every 3 weeks (75 mg/m(2)). A response in 3 of the first 21 patients was required to continue accrual to the target sample size of 50 patients.

RESULTS

Confirmed responses included 1 complete response (1.8%), 10 partial responses (18.2%), and 20 with stable disease (36.4%). The response rate was 20% (95% confidence interval [CI], 10.4% to 33.0%) and median time to disease progression was 104 days. There were no differences in PK parameters of docetaxel alone or with cetuximab. The most common grade 3 of 4 adverse events were leukopenia (27.3%) and acne (21.8%). Four patients (7.3%) discontinued due to allergic reaction. The median overall survival (OS) was 7.5 months with a 1-year survival of 35%.

CONCLUSIONS

Cetuximab in combination with docetaxel was well tolerated. The response rate supports more definitive evaluation of this combination in the second-line setting.

摘要

背景

对西妥昔单抗联合多西他赛用于晚期非小细胞肺癌(NSCLC)化疗难治/耐药患者进行研究,以确定缓解率、生存率、安全性和药代动力学(PK)。

方法

患者有表皮生长因子受体(EGFR)表达证据(≥1+)且在化疗期间出现肿瘤进展或化疗后3个月内疾病复发。西妥昔单抗每周给药(初始剂量400mg/m²;此后250mg/m²)。多西他赛每3周给药(75mg/m²)。前21例患者中需有3例出现缓解才能继续纳入研究,直至达到50例患者的目标样本量。

结果

确认的缓解包括1例完全缓解(1.8%)、10例部分缓解(18.2%)和20例病情稳定(36.4%)。缓解率为20%(95%置信区间[CI],10.4%至33.0%),疾病进展的中位时间为104天。单独使用多西他赛或与西妥昔单抗联合使用时,其PK参数无差异。最常见的3/4级不良事件为白细胞减少(27.3%)和痤疮(21.8%)。4例患者(7.3%)因过敏反应停药。中位总生存期(OS)为7.5个月,1年生存率为35%。

结论

西妥昔单抗联合多西他赛耐受性良好。缓解率支持在二线治疗中对该联合方案进行更确切的评估。

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