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培美曲塞治疗难治性软组织肉瘤患者:德国肉瘤研究组 AIO-STS 005 非对照多中心 II 期研究。

Pemetrexed in patients with refractory soft tissue sarcoma: a non-comparative multicenter phase II study of the German Sarcoma Group AIO-STS 005.

机构信息

Department of Medical Oncology, University Hospital of Schleswig-Holstein, Christian-Albrechts-University Kiel, Kiel, Germany.

出版信息

Invest New Drugs. 2013 Feb;31(1):167-74. doi: 10.1007/s10637-012-9840-8. Epub 2012 Jul 5.

Abstract

BACKGROUND

This study evaluated efficacy and safety of pemetrexed in patients with refractory soft tissue sarcoma.

METHODS

Patients received pemetrexed intravenously at a dose of 500 mg/m² every 21 days until progression or unacceptable toxicity. The primary endpoint was objective tumor response.

RESULTS

Fourty-eight of 53 screened patients were included and received a total of 200 cycles (median 2; range 1-30). Median age was 53 years (range, 20-81). The observed toxicity profile was favorable. NCI-CTC hematologic grade 3/4 toxicity consisted of neutropenia in 13 %, anemia in 15 %, and febrile neutropenia in 4 % of patients of patients, respectively. Non-hematologic CTC grade 3/4 toxicity consisted of elevated ASAT/ALAT in 10 %, hyperglycemia in 6 %, infection with or without neutropenia in 6 %, nausea in 2 % and stomatitis in 2 % of patients. No other grade 3 toxicities and no treatment-related toxic deaths were observed. Overall response as defined by RECIST was 5 %, 16 patients experienced stable disease (40 %). The estimated 3- and 6-months progression-free rates were 33.3 % and 14.6 %, respectively.

CONCLUSIONS

In patients with refractory STS, pemetrexed is well tolerated and moderately effective. The confirmed objective response rate in STS is low, however, disease stabilizations are seen in a high proportion of patients (ClinicalTrials.gov NCT00427466).

摘要

背景

本研究评估了培美曲塞治疗难治性软组织肉瘤患者的疗效和安全性。

方法

患者接受培美曲塞静脉滴注,剂量为 500mg/m²,每 21 天一次,直到疾病进展或出现不可接受的毒性。主要终点为客观肿瘤反应。

结果

53 例筛选患者中有 48 例入组并接受了总共 200 个周期(中位数 2;范围 1-30)。中位年龄为 53 岁(范围 20-81)。观察到的毒性谱是有利的。NCI-CTC 血液学 3/4 级毒性包括中性粒细胞减少症 13%、贫血 15%和发热性中性粒细胞减少症 4%,分别。非血液学 CTC 3/4 级毒性包括天冬氨酸转氨酶/丙氨酸转氨酶升高 10%、高血糖 6%、感染伴或不伴中性粒细胞减少症 6%、恶心 2%和口腔炎 2%。未观察到其他 3 级毒性和治疗相关毒性死亡。根据 RECIST 定义的总体缓解率为 5%,16 例患者病情稳定(40%)。估计的 3 个月和 6 个月无进展生存率分别为 33.3%和 14.6%。

结论

在难治性 STS 患者中,培美曲塞耐受性良好且疗效适度。STS 中确认的客观缓解率较低,但疾病稳定在很大比例的患者中可见(ClinicalTrials.gov NCT00427466)。

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