Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
Oncologist. 2010;15(12):1310-9. doi: 10.1634/theoncologist.2010-0152. Epub 2010 Dec 10.
The Cancer and Leukemia Group B (CALGB) conducted a phase II study evaluating sunitinib in patients with progressive metastatic pancreas adenocarcinoma following prior gemcitabine-based therapy (trial CALGB 80603; ClinicalTrials.gov identifier, NCT00397787). The primary endpoint was to determine the disease control rate (DCR) as measured by the Response Evaluation Criteria in Solid Tumors (complete response, partial response [PR], and stable disease) at 6 weeks.
Patients aged ≥18 years with an Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2 and with progressive pancreas adenocarcinoma following treatment with gemcitabine were eligible. Sunitinib was dosed at 50 mg orally days 1-28, every 42 days (1 cycle). The statistical plan called for a three-stage design. A DCR ≥15% was considered worthy of further study.
In total, 77 patients were enrolled. Forty-two (54.6%) enrollees were male. The median age was 65 years. The ECOG performance status score distribution was: 0, 39%; 1, 50%; 2, 11%. The DCR was 21.6%; one patient (1.4%) had a PR and 15 patients (20.3%) had stable disease as their best response. The progression-free survival time was 1.31 months (95% confidence interval [CI] 1.25-1.38 months) and overall survival time was 3.68 months (95% CI, 3.06-4.24 months).
The study met its primary endpoint; however sunitinib had minimal activity and moderate toxicity in a population of gemcitabine-refractory pancreas adenocarcinoma patients. For future studies, limiting enrollment to patients with an ECOG performance status score of 0-1 is recommended.
癌症和白血病组 B(CALGB)进行了一项 II 期研究,评估了舒尼替尼在接受吉西他滨为基础的治疗后进展性转移性胰腺腺癌患者中的作用(试验 CALGB 80603;ClinicalTrials.gov 标识符,NCT00397787)。主要终点是根据实体瘤反应评估标准(完全缓解、部分缓解[PR]和稳定疾病)在 6 周时确定疾病控制率(DCR)。
年龄≥18 岁,ECOG 表现状态评分为 0-2,接受吉西他滨治疗后进展性胰腺腺癌的患者符合条件。舒尼替尼的剂量为 50mg 口服,第 1-28 天,每 42 天(1 个周期)。统计计划采用三阶段设计。DCR≥15%被认为值得进一步研究。
共有 77 名患者入组。42 名(54.6%)患者为男性。中位年龄为 65 岁。ECOG 表现状态评分分布为:0,39%;1,50%;2,11%。DCR 为 21.6%;1 名患者(1.4%)有 PR,15 名患者(20.3%)最佳反应为稳定疾病。无进展生存期为 1.31 个月(95%置信区间[CI]1.25-1.38 个月),总生存期为 3.68 个月(95%CI,3.06-4.24 个月)。
该研究达到了主要终点;然而,舒尼替尼在吉西他滨耐药的胰腺腺癌患者中活性较低,毒性中等。对于未来的研究,建议将入组患者的 ECOG 表现状态评分限制在 0-1。