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贝伐单抗联合铂类化疗:用于晚期非小细胞肺癌

Bevacizumab plus platinum-based chemotherapy: in advanced non-small cell lung cancer.

作者信息

Wagstaff Antona J, Keam Susan J, McCormack Paul L

机构信息

Wolters Kluwer Health mid R: Adis, Auckland, New Zealand, an editorial office of Wolters Kluwer Health, Philadelphia, Pennsylvania, USA.

出版信息

BioDrugs. 2009;23(3):187-96. doi: 10.2165/00063030-200923030-00005.

Abstract

black triangle Bevacizumab is a recombinant, humanized vascular endothelial growth factor (VEGF) monoclonal antibody that inhibits tumor growth and tumor metastases. VEGF stimulates angiogenesis in tumors, is involved in early metastatic processes, and is overexpressed in non-small cell lung cancer (NSCLC). black triangle The addition of bevacizumab to standard chemotherapy significantly delayed disease progression in two large, randomized, phase III trials in chemotherapy-naive patients with advanced, nonsquamous NSCLC. In the open-label E4599 trial, median overall survival duration was significantly extended by 2 months and median progression-free survival was significantly increased by 1.7 months when intravenous bevacizumab 15 mg/kg once every 3 weeks was added to first-line carboplatin/paclitaxel therapy compared with carboplatin/paclitaxel alone. black triangle In the double-blind AVAiL trial, median progression-free survival was significantly increased (by 0.6 and 0.4 months) by the addition of intravenous bevacizumab 7.5 or 15 mg/kg once every 3 weeks to first-line cisplatin/gemcitabine therapy compared with placebo plus cisplatin/gemcitabine. However, median overall survival duration was not significantly improved (13.6 and 13.4 months vs 13.1 months). black triangle Response rates in the E4599 and AVAiL trials were 30-35% in patients receiving bevacizumab plus platinum-based chemotherapy compared with 15% and 20% without bevacizumab. black triangle The safety and tolerability profile of bevacizumab-containing treatment regimens in patients with advanced NSCLC was generally manageable in the E4599 and AVAiL trials, and in two large, ongoing, trials (the open-label SAiL and the observational ARIES studies).

摘要

黑三角 贝伐单抗是一种重组人源化血管内皮生长因子(VEGF)单克隆抗体,可抑制肿瘤生长和转移。VEGF刺激肿瘤血管生成,参与早期转移过程,且在非小细胞肺癌(NSCLC)中过表达。黑三角 在两项针对初治晚期非鳞状NSCLC患者的大型随机III期试验中,在标准化疗基础上加用贝伐单抗显著延迟了疾病进展。在开放标签的E4599试验中,与单纯使用卡铂/紫杉醇相比,在一线卡铂/紫杉醇治疗中每3周静脉注射一次15mg/kg贝伐单抗,中位总生存期显著延长2个月,中位无进展生存期显著增加1.7个月。黑三角 在双盲AVAIL试验中,与安慰剂加顺铂/吉西他滨相比,在一线顺铂/吉西他滨治疗中每3周静脉注射一次7.5或15mg/kg贝伐单抗,中位无进展生存期显著增加(分别增加0.6个月和0.4个月)。然而,中位总生存期未得到显著改善(分别为13.6个月、13.4个月和13.1个月)。黑三角 在E4599和AVAIL试验中,接受贝伐单抗加铂类化疗的患者缓解率为30%-35%,而未使用贝伐单抗的患者缓解率分别为15%和20%。黑三角 在E4599和AVAIL试验以及两项正在进行的大型试验(开放标签的SAIL试验和观察性ARIES研究)中,晚期NSCLC患者含贝伐单抗治疗方案的安全性和耐受性总体上是可控的。

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