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索拉非尼在 II 期随机停药试验中晚期软组织肉瘤亚组患者中的疗效和安全性。

Efficacy and safety of sorafenib in a subset of patients with advanced soft tissue sarcoma from a Phase II randomized discontinuation trial.

机构信息

The Royal Marsden Hospital, Downs Rd, Sutton, Surrey, SM2 5PT, UK.

出版信息

Invest New Drugs. 2011 Jun;29(3):481-8. doi: 10.1007/s10637-009-9367-9. Epub 2009 Dec 18.

Abstract

AIM

Phase II multi-disease randomized discontinuation trial to assess the safety and efficacy of sorafenib including patients with advanced soft tissue sarcoma (STS).

METHODS

Sorafenib (400 mg twice daily) was initially administered for 12 weeks. Patients with: ≥25% tumour shrinkage continued sorafenib; ≥25% tumour growth discontinued; other patients were randomized and received sorafenib or placebo.

RESULTS

Twenty-six patients (median age 55 years) were enrolled. Common drug-related adverse events, including fatigue, hand-foot skin reaction, rash or gastrointestinal disturbances, were manageable, reversible and generally low grade. Fatigue, skin toxicity, nausea, diarrhoea and hypertension occurred at grade ≥3 in 19% of patients. After 12 weeks eight (31%) patients had not progressed. Three patients who experienced tumour shrinkage and continued on sorafenib, and five (19%) were randomized either to continue sorafenib or to receive placebo. Of the three patients randomized to sorafenib, one achieved a partial response and two had SD. Overall one patient achieved a partial response and three further patients achieved minor responses.

CONCLUSIONS

There was evidence of disease activity in STS as defined by tumor regressions including one objective partial response. Further investigation in STS is warranted.

摘要

目的

评估索拉非尼(sorafenib)治疗包括晚期软组织肉瘤(STS)患者在内的多种疾病的安全性和疗效的 II 期多疾病随机停药试验。

方法

首先给予索拉非尼(400mg,每日两次)治疗 12 周。对于:肿瘤缩小≥25%的患者继续服用索拉非尼;肿瘤生长≥25%的患者停药;其他患者进行随机分组,接受索拉非尼或安慰剂治疗。

结果

共纳入 26 名患者(中位年龄 55 岁)。常见的药物相关不良反应,包括疲劳、手足皮肤反应、皮疹或胃肠道紊乱,可管理、可逆转且通常为低级别。19%的患者出现≥3 级的疲劳、皮肤毒性、恶心、腹泻和高血压。12 周后,8 名(31%)患者无进展。3 名肿瘤缩小并继续服用索拉非尼的患者,以及 5 名(19%)患者被随机分为继续服用索拉非尼或服用安慰剂。在随机分配至索拉非尼的 3 名患者中,1 名患者达到部分缓解,2 名患者疾病稳定。总体上,1 名患者达到部分缓解,另有 3 名患者达到轻微缓解。

结论

STS 存在疾病活动的证据,包括肿瘤消退的 1 个客观部分缓解。有必要进一步在 STS 中进行研究。

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