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培美曲塞(力比泰,LY231514,IND #40061)治疗复发性或持续性子宫内膜癌的II期评估:妇科肿瘤学II期研究

A phase II evaluation of pemetrexed (Alimta, LY231514, IND #40061) in the treatment of recurrent or persistent endometrial carcinoma: a phase II study of the Gynecologic Oncology.

作者信息

Miller David Scott, Blessing John A, Drake Richard D, Higgins Robert, McMeekin D Scott, Puneky Louis V, Krasner Carolyn N

机构信息

Division of Gynecologic Oncology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Room J7-124, Dallas, TX 75390-9032, USA.

出版信息

Gynecol Oncol. 2009 Dec;115(3):443-6. doi: 10.1016/j.ygyno.2009.09.004. Epub 2009 Oct 4.

Abstract

OBJECTIVE

To estimate the anti-tumor activity of pemetrexed in patients with advanced or recurrent carcinoma of the endometrium and to determine the nature and degree of toxicity.

METHODS

A multicenter phase II trial was conducted by the Gynecologic Oncology Group (GOG). Patients must have had advanced or recurrent measurable carcinoma of the endometrium and failed one prior chemotherapy regimen. Pemetrexed at a dose of 900 mg/m(2) was administered as an IV infusion over 10 min every 21 days.

RESULTS

From May 1, 2006 to July 31, 2007, 27 patients were entered by 10 member institutions of the GOG with two patients being deemed ineligible. A total of 101 cycles were administered with 28% of patients receiving five or more cycles. Overall, the treatment was well tolerated. More serious toxicities (grade 3 and 4) included anemia in 20%, leukopenia in 40%, neutropenia in 48%, and constitutional in 16%. No treatment-related deaths were reported. One patient (4%) had a partial response. Eleven patients (44%) had stable disease and eleven (44%) patients had increasing disease. Response could not be assessed in two patients (7%). Median progression-free survival was 2.7 months and overall survival was 9.4 months.

CONCLUSION

Pemetrexed has minimal activity in the treatment of recurrent or persistent endometrial carcinoma at the dose and schedule tested.

摘要

目的

评估培美曲塞对晚期或复发性子宫内膜癌患者的抗肿瘤活性,并确定毒性的性质和程度。

方法

由妇科肿瘤学组(GOG)进行一项多中心II期试验。患者必须患有晚期或复发性可测量的子宫内膜癌,且之前的一种化疗方案失败。培美曲塞剂量为900mg/m²,每21天静脉输注10分钟。

结果

从2006年5月1日至2007年7月31日,GOG的10个成员机构纳入了27例患者,其中2例被认为不符合条件。共进行了101个周期的治疗,28%的患者接受了5个或更多周期的治疗。总体而言,治疗耐受性良好。更严重的毒性(3级和4级)包括贫血20%、白细胞减少40%、中性粒细胞减少48%和全身性毒性16%。未报告与治疗相关的死亡。1例患者(4%)有部分缓解。11例患者(44%)疾病稳定,11例患者(44%)疾病进展。2例患者(7%)无法评估缓解情况。无进展生存期的中位数为2.7个月,总生存期为9.4个月。

结论

在所测试的剂量和方案下培美曲塞对复发性或持续性子宫内膜癌的治疗活性极小。

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