The Drug Development Unit, The Institute of Cancer Research, Sutton, UK.
Oncology. 2011;81(2):135-40. doi: 10.1159/000330206. Epub 2011 Oct 6.
First-line treatment options utilizing chemotherapy and cytokine-based treatments for patients with metastatic melanoma (MM) are unsatisfactory. We analyzed the clinical outcomes of patients with MM treated in phase I trials of novel agents. We hypothesized that patients included in phase I clinical trials did not have worse outcomes than with the chemotherapy and cytokine-based first-line treatment.
Data of patients with MM treated at The Drug Development Unit between 2004 and 2010 were collected. The response rate (RR) and time to progression (TTP) for first-line therapy were compared to those of phase I trial therapy. Patients acted as their own controls for statistical analyses.
Sixty-five patients were treated in 31 phase I trials. First-line treatment included dacarbazine or temozolomide in 58 (89%) cases and interferon-α in 5 patients (8%) and cisplatin-based treatment in 2 patients (3%). There was no significant difference in either the RR (11 vs. 14%, p = 0.87) or TTP (90 vs. 53 days, p = 0.15) in patients treated with first-line treatment versus phase I treatment, respectively.
Phase I clinical trials of molecularly targeted agents show clinical activity that is not dissimilar to that of treatment with existing chemotherapy and cytokine-based treatment.
对于转移性黑色素瘤(MM)患者,利用化疗和细胞因子治疗的一线治疗方案并不令人满意。我们分析了在新型药物 I 期临床试验中治疗 MM 患者的临床结果。我们假设,入组 I 期临床试验的患者的结局不会比接受化疗和细胞因子一线治疗更差。
收集了 2004 年至 2010 年在药物开发部治疗的 MM 患者的数据。比较了一线治疗的缓解率(RR)和无进展时间(TTP)与 I 期试验治疗的结果。患者自身作为对照进行统计分析。
31 项 I 期试验中治疗了 65 例患者。一线治疗包括达卡巴嗪或替莫唑胺 58 例(89%),干扰素-α 5 例(8%),顺铂 2 例(3%)。一线治疗与 I 期治疗的 RR(11%比 14%,p=0.87)或 TTP(90 天比 53 天,p=0.15)均无显著差异。
针对分子靶向药物的 I 期临床试验显示出的临床活性与现有化疗和细胞因子治疗的活性相似。