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马妥珠单抗联合氟尿嘧啶、亚叶酸钙和顺铂(PLF)治疗晚期胃及胃食管腺癌患者的 I 期研究。

Phase I study of matuzumab in combination with 5-fluorouracil, leucovorin and cisplatin (PLF) in patients with advanced gastric and esophagogastric adenocarcinomas.

机构信息

Department of Medicine (Cancer Research), West German Cancer Center, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany.

出版信息

Invest New Drugs. 2013 Jun;31(3):642-52. doi: 10.1007/s10637-012-9848-0. Epub 2012 Jul 5.

Abstract

BACKGROUND

To evaluate the safety and tolerability of two different weekly doses of the fully humanized epidermal growth factor receptor (EGFR)-targeting monoclonal antibody matuzumab combined with high-dose 5-fluorouracil, leucovorin and cisplatin (PLF) in the first-line treatment of patients with EGFR-positive advanced gastric and esophagogastric adenocarcinomas.

METHODS

Patients were treated in two matuzumab dose groups with the first cohort of patients receiving 400 mg matuzumab in combination with PLF. Based on the safety observations the next cohort of patients received 800 mg matuzumab. The study was conducted in two parts, with phase A, designed to assess the safety and tolerability of the combination, and phase B designed to be a treatment continuation for those patients benefiting from treatment. Treatment cycles were 7 weeks each. Each patient received the dose of matuzumab they were assigned to at study entry for the duration of the study.

RESULTS

Fifteen EGFR-positive patients were enrolled into the two matuzumab dose groups; 400 mg dose n=7; 800 mg dose n=8. All patients experienced at least one adverse event (AE). No patient experienced any serious AE which was considered to be related to matuzumab. Two grade 3 AEs possibly related to matuzumab occurred in 2 different patients (13.3 %), both in the 800 mg dose group. No dose-limiting toxicity (DLT) was observed in the 400 mg group. The maximum tolerated dose of matuzumab was not reached. The best confirmed overall response rate was 26.7 %.

CONCLUSION

Matuzumab, in combination with PLF, demonstrated an acceptable safety profile with modest anti-tumor activity.

摘要

背景

评估两种不同剂量的全人源化表皮生长因子受体(EGFR)靶向单克隆抗体马妥珠单抗联合高剂量 5-氟尿嘧啶、亚叶酸钙和顺铂(PLF)在一线治疗 EGFR 阳性晚期胃和食管胃结合部腺癌患者中的安全性和耐受性。

方法

患者分为两个马妥珠单抗剂量组,第一组患者接受 400mg 马妥珠单抗联合 PLF 治疗。根据安全性观察结果,第二组患者接受 800mg 马妥珠单抗治疗。该研究分为两部分,第一部分评估联合治疗的安全性和耐受性,第二部分为对受益于治疗的患者进行治疗延续。每个治疗周期为 7 周。每位患者在研究期间均接受入组时分配的马妥珠单抗剂量。

结果

15 名 EGFR 阳性患者被纳入两个马妥珠单抗剂量组;400mg 剂量组 n=7;800mg 剂量组 n=8。所有患者均至少经历了一次不良事件(AE)。没有患者发生任何被认为与马妥珠单抗相关的严重 AE。两名患者(13.3%)发生了两例可能与马妥珠单抗相关的 3 级 AE,均在 800mg 剂量组。400mg 剂量组未观察到剂量限制毒性(DLT)。未达到马妥珠单抗的最大耐受剂量。最佳确认的总缓解率为 26.7%。

结论

马妥珠单抗联合 PLF 具有可接受的安全性特征,抗肿瘤活性适度。

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