North Mississippi Hematology & Oncology Associates LTD, Tupelo, MO, USA.
Curr Med Res Opin. 2010 Oct;26(10):2339-46. doi: 10.1185/03007995.2010.510051.
Eltrombopag, an oral, nonpeptide thrombopoietin receptor agonist, has been shown to increase platelet counts in adults with chronic immune thrombocytopenia and chronic hepatitis C. This multicenter phase 2 study assessed the efficacy and safety of eltrombopag in patients receiving first-line carboplatin/paclitaxel for the treatment of advanced solid tumors.
Patients (N = 183) were randomized to placebo or eltrombopag 50 mg, 75 mg, or 100 mg given orally following chemotherapy on days 2 through 11 of each 21-day cycle, for at least two cycles. The primary endpoint was the difference in platelet count from day 1 in cycle 2 to the platelet nadir in cycle 2.
NCT00102726.
Although the primary endpoint was not met, postnadir platelet counts increased during cycles 1 and 2 in all eltrombopag treatment groups compared with placebo. The most commonly reported adverse events across all study arms (including placebo) were nausea and alopecia and eltrombopag was generally well tolerated.
This study provides preliminary information that eltrombopag does increase platelets in patients receiving chemotherapy for advanced solid tumors. Further investigation is needed to identify the optimal dose(s) and schedule of eltrombopag in patients receiving myelosuppressive chemotherapy.
血小板生成素受体激动剂艾曲波帕为口服、非肽类药物,已被证明可增加慢性免疫性血小板减少症和慢性丙型肝炎成人的血小板计数。这项多中心 2 期研究评估了艾曲波帕在接受一线卡铂/紫杉醇治疗晚期实体瘤的患者中的疗效和安全性。
患者(N=183)按 21 天周期的第 2 天至第 11 天化疗后接受安慰剂或艾曲波帕 50mg、75mg 或 100mg 口服随机分组,至少接受两个周期。主要终点是第 2 周期第 2 天的血小板计数与第 2 周期血小板最低点之间的差异。
NCT00102726。
尽管主要终点未达到,但与安慰剂相比,所有艾曲波帕治疗组在第 1 周期和第 2 周期的血小板最低点后计数均增加。所有研究组(包括安慰剂)中最常报告的不良事件是恶心和脱发,艾曲波帕通常耐受良好。
这项研究提供了初步信息,表明艾曲波帕可增加接受化疗治疗晚期实体瘤患者的血小板计数。需要进一步研究以确定在接受骨髓抑制性化疗的患者中艾曲波帕的最佳剂量和方案。