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北美癌症治疗合作组(NCCTG)N0432 研究:多西紫杉醇联合卡培他滨和贝伐珠单抗一线治疗转移性乳腺癌的Ⅱ期临床试验。

North Central Cancer Treatment Group (NCCTG) N0432: phase II trial of docetaxel with capecitabine and bevacizumab as first-line chemotherapy for patients with metastatic breast cancer.

机构信息

Multidisciplinary Breast Clinic and Breast Cancer Program, Mayo Clinic, Jacksonville, FL.

Mayo Clinic, Rochester, MN.

出版信息

Ann Oncol. 2010 Feb;21(2):269-274. doi: 10.1093/annonc/mdp512. Epub 2009 Nov 9.

Abstract

BACKGROUND

Docetaxel (T; Taxotere) with capecitabine (X) is active against metastatic breast cancer (MBC); bevacizumab (BV) has demonstrated efficacy with taxanes in the first-line setting. This study was conducted to assess the safety and efficacy of TX-BV in patients with MBC.

PATIENTS AND METHODS

In this single-arm, multicenter phase II study, patients received first-line bevacizumab 15 mg/kg and docetaxel 75 mg/m(2) on day 1 and capecitabine 825 mg/m(2) twice per day on days 1-14 every 21 days. Primary and secondary end points were tumor response rate (RR), overall survival (OS), progression-free survival (PFS), and toxicity.

RESULTS

A total of 45 assessable patients received TX-BV for a median of seven cycles. Two complete and 20 partial responses were observed (overall RR 49%); nine patients had stable disease >6 months, for a clinical benefit rate of 69%. Median response duration was 11.8 months. Median OS and PFS were 28.4 and 11.1 months, respectively. Grade 3/4 adverse events included hand-foot syndrome (29%), fatigue (20%), febrile neutropenia (18%), and diarrhea (18%). In cycles 3-10, median dose levels of docetaxel and capecitabine were 60 mg/m(2) and 660 mg/m(2), respectively.

CONCLUSION

TX-BV demonstrated significant activity; dose modifications were required to manage drug-related toxic effects.

摘要

背景

多西他赛(T;泰索帝)联合卡培他滨(X)对转移性乳腺癌(MBC)有效;贝伐珠单抗(BV)在一线治疗中与紫杉烷类药物联合显示出疗效。本研究旨在评估 TX-BV 方案在 MBC 患者中的安全性和有效性。

患者和方法

这是一项单臂、多中心的 II 期研究,患者接受贝伐珠单抗 15mg/kg 和多西他赛 75mg/m(2),第 1 天,卡培他滨 825mg/m(2),每日 2 次,第 1-14 天,每 21 天 1 次。主要和次要终点为肿瘤缓解率(RR)、总生存期(OS)、无进展生存期(PFS)和毒性。

结果

共 45 例可评估患者接受 TX-BV 治疗,中位治疗周期数为 7 个。2 例完全缓解,20 例部分缓解(总体 RR 为 49%);9 例患者疾病稳定>6 个月,临床获益率为 69%。中位缓解持续时间为 11.8 个月。中位 OS 和 PFS 分别为 28.4 个月和 11.1 个月。3/4 级不良事件包括手足综合征(29%)、乏力(20%)、发热性中性粒细胞减少症(18%)和腹泻(18%)。在第 3-10 个周期中,多西他赛和卡培他滨的中位剂量分别为 60mg/m(2)和 660mg/m(2)。

结论

TX-BV 方案具有显著的活性;需要调整剂量以控制药物相关的毒性作用。

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