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首个人体研究:伊立替康载药微球(DEBIRI)治疗结直肠癌不可切除肝转移。

First human study in treatment of unresectable liver metastases from colorectal cancer with irinotecan-loaded beads (DEBIRI).

机构信息

Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe-University, D-60590 Frankfurt, Germany.

出版信息

Int J Oncol. 2012 Oct;41(4):1213-20. doi: 10.3892/ijo.2012.1572. Epub 2012 Jul 25.

Abstract

The objective of this pilot clinical study was to assess the safety, technical feasibility, pharmacokinetic (PK) profile and tumour response of DC Bead™ with irinotecan (DEBIRI™) delivered by intra-arterial embolisation for the treatment of metastatic colorectal cancer. Eleven patients with unresectable liver metastases from CRC, tumour burden <30% of liver volume, adequate haematological, liver and renal function, performance status of <2 were included in this study. Patients received up to 4 sessions of TACE with DEBIRI at 3-week intervals. Feasibility of the procedure, safety and tumour response were assessed after each cycle. PK was measured after the first cycle. Patients were followed up to 24 weeks. Only mild to moderate adverse events were observed. DEBIRI is a technically feasibile procedure; no technical complications were observed. Average Cmax for irinotecan and SN-38 was 194 ng/ml and 16.7 ng/ml, respectively, with average t½ of 4.6 h and 12.4 h following administration of DEBIRI. Best overall response during the study showed disease control in 9 patients (2 patients with partial response and 7 with stable disease, overall response rate of 18%). Our study shows that transarterial chemoembolisation with irinotecan-loaded DC beads (DEBIRI) is safe, technically feasible and effective with a good PK profile.

摘要

本临床研究旨在评估经动脉栓塞术(TACE)递送载伊立替康的 DC 微球(DEBIRI)治疗转移性结直肠癌(mCRC)的安全性、技术可行性、药代动力学(PK)特征和肿瘤反应。11 例 mCRC 患者存在不可切除的肝转移病灶,肿瘤负荷<30%肝脏体积,血液学、肝脏和肾功能充足,表现状态<2,纳入本研究。患者每 3 周接受 1-4 次 TACE 联合 DEBIRI 治疗。每周期后评估手术的可行性、安全性和肿瘤反应。第 1 周期后测量 PK。患者随访 24 周。仅观察到轻微至中度不良事件。DEBIRI 是一种可行的技术操作;未观察到技术并发症。伊立替康和 SN-38 的平均 Cmax 分别为 194ng/ml 和 16.7ng/ml,给予 DEBIRI 后,平均 t1/2 分别为 4.6h 和 12.4h。研究期间的最佳总体反应显示 9 例患者(2 例部分缓解,7 例疾病稳定,总缓解率为 18%)疾病得到控制。我们的研究表明,经动脉化疗栓塞术联合伊立替康载药 DC 微球(DEBIRI)具有良好的 PK 特征,安全、技术可行且有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e60f/3583653/a823b7566638/IJO-41-04-1213-g00.jpg

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