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索拉非尼联合奥曲肽治疗晚期肝细胞癌的多中心 II 期 So.LAR.研究:有效且安全。

Sorafenib plus octreotide is an effective and safe treatment in advanced hepatocellular carcinoma: multicenter phase II So.LAR. study.

机构信息

Medical Oncology Unit, San Giovanni di Dio Hospital, Via Giovanni XXII, 80020, Frattaminore, Naples, Italy.

出版信息

Cancer Chemother Pharmacol. 2010 Oct;66(5):837-44. doi: 10.1007/s00280-009-1226-z. Epub 2009 Dec 30.

DOI:10.1007/s00280-009-1226-z
PMID:20041325
Abstract

PURPOSE

Advanced hepatocellular carcinoma (HCC) not eligible for local therapies has limited chances of cure. Sorafenib is a multikinase inhibitor with proven activity in advanced HCC. Octreotide is used in this setting with conflicting results. Treatment with sorafenib and long-acting octreotide was tested in advanced HCC to evaluate safety and activity.

METHODS

Fifty patients with advanced HCC, Child-Pugh A or B, received sorafenib at a dosage of 800 mg/day for 28 days with a following week of rest and long-acting octreotide at a dose of 40 mg, administered every 28 days.

RESULTS

All patients were assessable for safety and efficacy. Sixteen patients out of 50 (34%) were naïve from other therapies, while all the others were previously treated with local and/or systemic treatments. We achieved 5 partial responses (10%), 33 stable diseases (66%) and 12 progressions of disease (24%). Median time to progression was 7.0 months (95% CI, 3.0-10.9 months), and median overall survival was 12 months (95% CI, 6.3-17.4 months). Treatment was well tolerated. Diarrhoea (6%) and hypertension (4%) were the most frequent grade 3 toxicities.

CONCLUSIONS

Our data suggest that the combination between sorafenib and long-acting octreotide is active and well tolerated in patients with advanced HCC and could represent another efficacious chance for the management of this population.

摘要

目的

不适合局部治疗的晚期肝细胞癌(HCC)治愈机会有限。索拉非尼是一种多激酶抑制剂,已被证明对晚期 HCC 有效。奥曲肽在这种情况下使用,但结果存在争议。在晚期 HCC 中测试了索拉非尼和长效奥曲肽的联合治疗,以评估其安全性和疗效。

方法

50 例 Child-Pugh A 或 B 的晚期 HCC 患者接受索拉非尼治疗,剂量为 800mg/天,连用 28 天,随后休息一周,再给予长效奥曲肽,剂量为 40mg,每 28 天给药一次。

结果

所有患者均可进行安全性和疗效评估。50 例患者中有 16 例(34%)为其他治疗方法初治患者,而其余所有患者均为局部和/或全身治疗的既往治疗患者。我们获得了 5 例部分缓解(10%)、33 例稳定疾病(66%)和 12 例疾病进展(24%)。中位无进展生存期为 7.0 个月(95%CI,3.0-10.9 个月),中位总生存期为 12 个月(95%CI,6.3-17.4 个月)。治疗耐受性良好。腹泻(6%)和高血压(4%)是最常见的 3 级毒性。

结论

我们的数据表明,索拉非尼和长效奥曲肽联合治疗在晚期 HCC 患者中具有活性且耐受性良好,可能为该人群的治疗提供另一种有效的选择。

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