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复发性铂类敏感型晚期卵巢癌患者接受两种不同每 3 周给药方案(1.5 mg/m2 24 小时或 1.3 mg/m2 3 小时)的 trabectedin 随机 II 期研究。

Phase II randomized study of trabectedin given as two different every 3 weeks dose schedules (1.5 mg/m2 24 h or 1.3 mg/m2 3 h) to patients with relapsed, platinum-sensitive, advanced ovarian cancer.

机构信息

Department of Medical Oncology, Vall d'Hebrón University Hospital, Barcelona, Spain.

出版信息

Ann Oncol. 2009 Nov;20(11):1794-802. doi: 10.1093/annonc/mdp198. Epub 2009 Jun 25.

DOI:10.1093/annonc/mdp198
PMID:19556318
Abstract

BACKGROUND

This randomized, open-label, phase II clinical trial evaluated the optimal regimen of trabectedin administered every 3 weeks in patients with platinum-sensitive, relapsed, advanced ovarian cancer (AOC).

PATIENTS AND METHODS

Patients previously treated with less than two or two previous chemotherapy lines were randomized to receive trabectedin 1.5 mg/m(2) 24 h (arm A, n = 54) or 1.3 mg/m(2) 3 h (arm B, n = 53). Objective response rate (ORR) per RECIST was the primary efficacy end point. Toxic effects were graded according to the National Cancer Institute-Common Toxicity Criteria v. 2.0.

RESULTS

ORR was 38.9% [95% confidence interval (CI) 25.9% to 53.1%; arm A] and 35.8% (95% CI 23.1% to 50.2%; arm B) (intention-to-treat primary analysis). Median time to progression was 6.2 months (95% CI 5.3-8.6 months; arm A) and 6.8 months (95% CI 4.6-7.4 months; arm B). Frequent severe adverse events were nausea/vomiting (24%, arm A; 15%, arm B) and fatigue (15%, arm A; 10%, arm B). Common severe laboratory abnormalities were transient, noncumulative neutropenia (55%, arm A; 37%, arm B) and transaminase increases (alanine aminotransferase, 55%, arm A; 59%, arm B).

CONCLUSIONS

Both every-3-weeks trabectedin regimes, 1.5 mg/m(2) 24 h and 1.3 mg/m(2) 3 h, were active and reasonably well tolerated in AOC platinum-sensitive patients. Trabectedin every-3-weeks has promising activity and deserves to be further evaluated in relapsed AOC.

摘要

背景

这是一项随机、开放标签、二期临床试验,评估了每周 3 次给予 trabectedin 的最佳方案,用于铂类敏感、复发、晚期卵巢癌(AOC)患者。

患者和方法

既往接受过少于两线或两线化疗的患者随机分为 trabectedin 1.5 mg/m²24 小时组(A 组,n=54)或 1.3 mg/m²3 小时组(B 组,n=53)。根据 RECIST 标准评估的客观缓解率(ORR)是主要疗效终点。毒性作用按国家癌症研究所通用毒性标准 v. 2.0 分级。

结果

ORR 为 38.9%(95%CI 25.9%至 53.1%;A 组)和 35.8%(95%CI 23.1%至 50.2%;B 组)(意向治疗主要分析)。中位无进展生存期为 6.2 个月(95%CI 5.3-8.6 个月;A 组)和 6.8 个月(95%CI 4.6-7.4 个月;B 组)。常见的严重不良事件为恶心/呕吐(24%,A 组;15%,B 组)和疲劳(15%,A 组;10%,B 组)。常见的严重实验室异常为短暂、非累积性中性粒细胞减少(55%,A 组;37%,B 组)和转氨酶升高(丙氨酸氨基转移酶,55%,A 组;59%,B 组)。

结论

每周 3 次的 trabectedin 方案(1.5 mg/m²24 小时和 1.3 mg/m²3 小时)在铂类敏感的 AOC 患者中均具有活性且耐受性良好。每周 3 次 trabectedin 具有良好的疗效,值得进一步在复发性 AOC 中进行评估。

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