Medical Oncology, Mount Vernon Cancer Centre, Northwood.
Department of Clinical Oncology, Beatson Oncology Centre, Gartnavel General Hospital, Glasgow.
Ann Oncol. 2011 Nov;22(11):2411-2416. doi: 10.1093/annonc/mdq780. Epub 2011 Mar 3.
Sagopilone, the first fully synthetic epothilone, has shown promising preclinical activity in tumour models. This open-label randomised phase II study investigated two infusion schedules of sagopilone in women with ovarian cancer.
Women with ovarian cancer recurring within 6 months of end of last platinum-containing treatment received sagopilone 16 mg/m(2) as a 3- or 0.5-h i.v. infusion every 21 days for up to 6 weeks.
Sixty-three patients received sagopilone as a 3-h (n=38) or 0.5-h (n=25) infusion. There were nine confirmed tumour responses [by modified RECIST (n=8) and by Gynecologic Cancer Intergroup CA-125 criteria (n=1)] in 57 patients assessable for efficacy overall [three (13%) with 0.5-h and six (18%) with 3-h infusions]. The 0.5-h arm was closed when it failed to meet its target efficacy. Main drug-related adverse events were peripheral sensory neuropathy (73%; 16% grade 3), nausea (37%; 2% grade 3), fatigue (35%; 3% grade 3) and arthralgia (30%; 5% grade 3). Overall incidence of peripheral sensory neuropathy was similar in both treatment arms, with no grade 4 neuropathy events. No acute allergic infusion reactions were observed.
Sagopilone is effective, with balanced tolerability, in patients with recurrent platinum-resistant ovarian cancer.
沙格司亭是第一个完全合成的埃坡霉素,在肿瘤模型中显示出有前景的临床前活性。这项开放标签的随机 2 期研究调查了沙格司亭在卵巢癌女性中的两种输注方案。
在末次含铂治疗结束后 6 个月内复发的卵巢癌女性患者接受沙格司亭 16mg/m²,作为 3 小时或 0.5 小时静脉输注,每 21 天一次,最多 6 周。
63 名患者接受了沙格司亭作为 3 小时(n=38)或 0.5 小时(n=25)输注。在可评估疗效的 57 名患者中,有 9 例确认肿瘤反应[根据改良 RECIST(n=8)和妇科癌症协作组 CA-125 标准(n=1)],其中 3 例(13%)接受 0.5 小时输注,6 例(18%)接受 3 小时输注。当 0.5 小时组未能达到其目标疗效时,该组被关闭。主要与药物相关的不良事件是周围感觉神经病(73%;16%为 3 级)、恶心(37%;2%为 3 级)、疲劳(35%;3%为 3 级)和关节痛(30%;5%为 3 级)。在两个治疗组中,周围感觉神经病的总发生率相似,没有 4 级神经病事件。没有观察到急性过敏输液反应。
沙格司亭对铂类耐药复发性卵巢癌患者有效,耐受性良好。