Gastrointestinal Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku 104-0045, Tokyo, Japan.
Invest New Drugs. 2012 Aug;30(4):1621-7. doi: 10.1007/s10637-011-9709-2. Epub 2011 Jul 5.
NK105 is a new drug delivery system formulation for paclitaxel (PTX) whose recommended dose (RD) is 150 mg PTX equivalent/m(2) administered every 3 weeks, as determined in a phase I trial. This study aimed to evaluate the efficacy and safety of NK105 in patients with advanced gastric cancer after failure of first-line chemotherapy.
Eligible patients had measurable disease and one chemotherapeutic regimen except taxane. NK105 (150 mg PTX equivalent/m(2)) was administered by a 30-minute intravenous infusion every 3 weeks without anti-allergic premedication until disease progression, unacceptable toxicity or patient refusal. The primary efficacy endpoint was best overall response rate (ORR) post baseline. The secondary endpoints were progression-free survival (PFS), time to treatment failure (TTF) and overall survival (OS). All adverse events were reported using CTCAE v3.0.
Between November 2007 and July 2009, 57 patients were enrolled and 56 were evaluable for efficacy. Two complete responses and 12 partial responses were observed for an ORR of 25%. The median PFS was 3.0 months, the median TTF was 2.8 months, and the median OS was 14.4 months. Drug related toxicity was mainly mild (grades 1-2) to severe (grades 3-4); other data: neutropenia (64.9%); leukopenia (17.5%); lymphopenia (8.8%); neuropathy-sensory (1.8%); fatigue (3.5%); and stomatitis (1.8%). There were no treatment-related deaths.
This study of NK105 (150 mg PTX equivalent/m(2)) proves the concept for the modest activity and tolerability of a new drug delivery system formulation for PTX. A phase III trial will be evaluated to clarify survival benefit.
NK105 是一种新型紫杉醇(PTX)药物输送系统制剂,其推荐剂量(RD)为 150mgPTX 当量/m2,每 3 周给药 1 次,这是在 I 期试验中确定的。本研究旨在评估 NK105 在一线化疗失败后的晚期胃癌患者中的疗效和安全性。
符合条件的患者有可测量的疾病,且在除紫杉烷以外的一种化疗方案中治疗过。NK105(150mgPTX 当量/m2)通过 30 分钟静脉输注,每 3 周 1 次,无需进行抗过敏预处理,直至疾病进展、无法耐受毒性或患者拒绝治疗。主要疗效终点为基线后最佳总缓解率(ORR)。次要终点为无进展生存期(PFS)、治疗失败时间(TTF)和总生存期(OS)。所有不良事件均采用 CTCAE v3.0 进行报告。
2007 年 11 月至 2009 年 7 月,共纳入 57 例患者,其中 56 例患者可进行疗效评估。2 例完全缓解,12 例部分缓解,总缓解率为 25%。中位 PFS 为 3.0 个月,中位 TTF 为 2.8 个月,中位 OS 为 14.4 个月。药物相关毒性主要为轻度(1-2 级)至重度(3-4 级);其他数据为中性粒细胞减少症(64.9%)、白细胞减少症(17.5%)、淋巴细胞减少症(8.8%)、感觉神经病变(1.8%)、乏力(3.5%)和口腔炎(1.8%)。无治疗相关死亡。
本研究证明了 NK105(150mgPTX 当量/m2)新型药物输送系统制剂对 PTX 具有一定的活性和可耐受性。将开展 III 期临床试验以明确其生存获益。