Stopeck Alison T, Unger Joseph M, Rimsza Lisa M, Bellamy William T, Iannone Maria, Persky Daniel O, Leblanc Michael, Fisher Richard I, Miller Thomas P
Arizona Cancer Center, University of Arizona, Tucson, AZ 85724-5024, USA.
Leuk Lymphoma. 2009 May;50(5):728-35. doi: 10.1080/10428190902856808.
This is the first report of the Southwest oncology group phase II trial of single agent bevacizumab in patients with relapsed, aggressive non-Hodgkin lymphoma (NHL). Fifty-two patients in first or second relapse with diffuse large B-cell or mantle cell lymphoma were enrolled. Patients were treated with bevacizumab at 10 mg/kg every 2 weeks. Therapy was well tolerated with no unexpected toxicities observed. Six-month progression-free survival (PFS) was 16% with a response rate of 2% and median duration of response or stable disease of 5.2 months (range 3.5-72.7). Vascular endothelial growth factor A (VEGF) and VEGF receptor expression was observed in 70% and 65% of specimens, respectively. In an exploratory subgroup analysis, baseline urine VEGF and plasma vascular cell adhesion molecule-1 (VCAM) levels correlated with survival. Prolonged PFS in several patients as well as biomarker studies suggest the VEGF pathway plays an important role in aggressive NHL. Clinical trials combining active chemotherapy regimens with VEGF targeted agents are currently in progress.
这是西南肿瘤协作组关于单药贝伐单抗治疗复发侵袭性非霍奇金淋巴瘤(NHL)患者的II期试验的首份报告。52例首次或二次复发的弥漫性大B细胞淋巴瘤或套细胞淋巴瘤患者入组。患者接受每2周10mg/kg的贝伐单抗治疗。治疗耐受性良好,未观察到意外毒性。6个月无进展生存期(PFS)为16%,缓解率为2%,缓解或疾病稳定的中位持续时间为5.2个月(范围3.5 - 72.7个月)。分别在70%和65%的标本中观察到血管内皮生长因子A(VEGF)和VEGF受体表达。在一项探索性亚组分析中,基线尿VEGF和血浆血管细胞黏附分子-1(VCAM)水平与生存相关。数例患者的PFS延长以及生物标志物研究提示VEGF通路在侵袭性NHL中起重要作用。目前正在进行将活性化疗方案与VEGF靶向药物联合的临床试验。