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一项在既往接受多西他赛治疗的转移性去势抵抗性前列腺癌患者中进行的紫杉醇类似物 patupilone 的 2 期研究:加拿大泌尿外科肿瘤学组研究 P07a。

A phase 2 study of patupilone in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel: Canadian Urologic Oncology Group study P07a.

机构信息

Department of Medical Oncology, BC Cancer Agency, Vancouver Centre, Vancouver.

Department of Medical Oncology, BC Cancer Agency, Vancouver Centre, Vancouver.

出版信息

Ann Oncol. 2012 Jan;23(1):53-58. doi: 10.1093/annonc/mdr336. Epub 2011 Jul 16.

Abstract

BACKGROUND

The purpose of this study was to determine the clinical activity of patupilone in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel.

PATIENTS AND METHODS

Eligible patients had progressive disease within 6 months of receiving docetaxel. Patupilone was administered 10 mg/m2 i.v. every 3 weeks. The primary end point was the proportion of patients with a confirmed≥50% prostate-specific antigen (PSA) decline.

RESULTS

Eighty-three patients were enrolled. At baseline, the median time to progression after prior docetaxel was 1.4 months (range 0-5.7). Gastrointestinal serious adverse events occurred in four of the six initial patients leading to a reduction of the starting dose of patupilone to 8 mg/m2 for subsequent patients. Grade 3-4 toxicity at this dose included diarrhea (22%), fatigue (21%), and anorexia (10%). One patient experienced grade 3-4 hematologic toxicity. A PSA decline of ≥50% occurred in 47% of patients. A partial measurable disease response occurred in 24% of assessable patients. A patient-reported pain response was observed in 59% of assessable patients. Median time to PSA progression was 6.1 months [95% confidence interval (CI) 4.7-8.0] and median overall survival was 11.3 months (95% CI 9.8-15.4).

CONCLUSIONS

Patupilone at 8 mg/m2 was tolerable, had antitumor activity, and was associated with symptomatic improvement in patients previously treated with docetaxel.

摘要

背景

本研究旨在确定多西他赛治疗后转移性去势抵抗性前列腺癌患者中培他泊龙的临床活性。

患者和方法

符合条件的患者在接受多西他赛治疗后 6 个月内疾病进展。培他泊龙静脉滴注 10mg/m2,每 3 周一次。主要终点是确认前列腺特异性抗原(PSA)下降≥50%的患者比例。

结果

83 名患者入组。在前瞻性分析中,先前接受多西他赛治疗后进展的中位时间为 1.4 个月(范围 0-5.7)。最初的 6 名患者中有 4 名发生了胃肠道严重不良事件,导致培他泊龙的起始剂量减少至 8mg/m2,用于后续患者。该剂量下 3-4 级毒性包括腹泻(22%)、疲劳(21%)和厌食(10%)。1 名患者出现 3-4 级血液学毒性。47%的患者 PSA 下降≥50%。24%的可评估患者出现部分可测量疾病缓解。59%的可评估患者出现患者报告的疼痛缓解。PSA 进展的中位时间为 6.1 个月[95%置信区间(CI)4.7-8.0],中位总生存期为 11.3 个月(95%CI 9.8-15.4)。

结论

培他泊龙 8mg/m2 耐受良好,具有抗肿瘤活性,并与先前接受多西他赛治疗的患者的症状改善相关。

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