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在未经治疗的晚期胃癌日本患者中,西地尼布联合顺铂加氟嘧啶(S-1 或卡培他滨)的 I 期研究。

Phase I study of cediranib in combination with cisplatin plus fluoropyrimidine (S-1 or capecitabine) in Japanese patients with previously untreated advanced gastric cancer.

机构信息

Kinki University School of Medicine, Osaka, Japan.

出版信息

Cancer Chemother Pharmacol. 2012 Feb;69(2):439-46. doi: 10.1007/s00280-011-1723-8. Epub 2011 Aug 19.

DOI:10.1007/s00280-011-1723-8
PMID:21853311
Abstract

PURPOSE

The primary objective of this Phase I study was to assess the safety and tolerability of the vascular endothelial growth factor signalling inhibitor cediranib in combination with cisplatin plus an oral fluoropyrimidine, in Japanese patients with previously untreated advanced gastric cancer.

METHODS

Patients received continuous, once-daily oral doses of cediranib 20 mg in combination with either cisplatin (60 mg/m(2) iv day 1) plus S-1 (40-60 mg bid, days 1-21) every 5 weeks for a maximum of eight cycles [Arm A]; or cisplatin (80 mg/m(2) iv, day 1) plus capecitabine (1,000 mg/m(2) bid, days 1-14) every 3 weeks for a maximum of six cycles [Arm B]. In both arms, the assessment period for dose-limiting toxicities (DLTs) was the first 21 days of cycle 1.

RESULTS

Fourteen patients (Arm A, n = 6; Arm B, n = 8) were enrolled and received at least one dose of cediranib. One patient in each arm experienced a DLT (Arm A; decreased appetite, grade 3; Arm B, decreased appetite, fatigue and hyponatraemia, all grade 3). Overall, the most common adverse events were decreased appetite, fatigue and nausea (all n = 13 [92.9%]). Preliminary efficacy evaluation showed one confirmed (Arm A) and three unconfirmed (Arm A, n = 1; Arm B, n = 2) partial responses that were ongoing at data cut-off.

CONCLUSIONS

Cediranib 20 mg/day in combination with cisplatin and S-1 or capecitabine was tolerable, with no new toxicities identified, and showed preliminary evidence of antitumour activity.

摘要

目的

本 I 期研究的主要目的是评估血管内皮生长因子信号抑制剂西地尼布联合顺铂和口服氟嘧啶类药物在未经治疗的晚期日本胃癌患者中的安全性和耐受性。

方法

患者接受连续每日一次口服西地尼布 20mg,联合顺铂(60mg/m2,iv,第 1 天)加 S-1(40-60mg,bid,第 1-21 天),每 5 周为一个周期,最多 8 个周期[A 组];或顺铂(80mg/m2,iv,第 1 天)加卡培他滨(1000mg/m2,bid,第 1-14 天),每 3 周为一个周期,最多 6 个周期[B 组]。在两组中,剂量限制毒性(DLT)评估期为第 1 周期的第 1-21 天。

结果

共纳入 14 例患者(A 组,n=6;B 组,n=8),至少接受过一次西地尼布治疗。每组各有 1 例患者出现 DLT(A 组:食欲下降,3 级;B 组:食欲下降、乏力和低钠血症,均为 3 级)。总体而言,最常见的不良反应为食欲下降、乏力和恶心(均为 n=13 [92.9%])。初步疗效评估显示,A 组有 1 例确认(1 例)和 3 例未确认(A 组,n=1;B 组,n=2)部分缓解,在数据截止时仍在进行中。

结论

西地尼布 20mg/天联合顺铂和 S-1 或卡培他滨可耐受,未发现新的毒性,且初步显示出抗肿瘤活性。

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