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
Department of Thoracic/Head & Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2009 Apr 15;115(8):1713-22. doi: 10.1002/cncr.24148.
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).
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.
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%.
Cetuximab in combination with docetaxel was well tolerated. The response rate supports more definitive evaluation of this combination in the second-line setting.
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)。
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。
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%。
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。