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贝伐珠单抗单药治疗复发性恶性脑胶质瘤日本患者的 II 期研究。

Phase II study of single-agent bevacizumab in Japanese patients with recurrent malignant glioma.

机构信息

Department of Neurosurgery, Kyorin University Faculty of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan.

出版信息

Jpn J Clin Oncol. 2012 Oct;42(10):887-95. doi: 10.1093/jjco/hys121. Epub 2012 Jul 27.

Abstract

OBJECTIVE

This single-arm, open-label, Phase II study evaluated the efficacy and safety of single-agent bevacizumab, a monoclonal antibody against vascular endothelial growth factor, in Japanese patients with recurrent malignant glioma.

METHODS

Patients with histologically confirmed, measurable glioblastoma or World Health Organization Grade III glioma, previously treated with temozolomide plus radiotherapy, received 10 mg/kg bevacizumab intravenous infusion every 2 weeks. The primary endpoint was 6-month progression-free survival in the patients with recurrent glioblastoma.

RESULTS

Of the 31 patients enrolled, 29 (93.5%) had glioblastoma and 2 (6.5%) had Grade III glioma. Eleven (35.5%) patients were receiving corticosteroids at baseline; 17 (54.8%) and 14 (45.2%) patients had experienced one or two relapses, respectively. The 6-month progression-free survival rate in the 29 patients with recurrent glioblastoma was 33.9% (90% confidence interval, 19.2-48.5) and the median progression-free survival was 3.3 months. The 1-year survival rate was 34.5% with a median overall survival of 10.5 months. There were eight responders (all partial responses) giving an objective response rate of 27.6%. The disease control rate was 79.3%. Eight of the 11 patients taking corticosteroids at baseline reduced their dose or discontinued corticosteroids during the study. Bevacizumab was well-tolerated and Grade ≥3 adverse events of special interest to bevacizumab were as follows: hypertension [3 (9.7%) patients], congestive heart failure [1 (3.2%) patient] and venous thromboembolism [1 (3.2%) patient]. One asymptomatic Grade 1 cerebral hemorrhage was observed, which resolved without treatment.

CONCLUSION

Single-agent bevacizumab provides clinical benefit for Japanese patients with recurrent glioblastoma.

摘要

目的

这项单臂、开放标签、2 期研究评估了贝伐珠单抗(一种针对血管内皮生长因子的单克隆抗体)单药治疗复发性恶性脑胶质瘤的疗效和安全性,该研究入组的患者均为日本人群。

方法

经组织学证实、可测量的胶质母细胞瘤或世界卫生组织(WHO)分级 III 级胶质瘤患者,先前接受过替莫唑胺联合放疗治疗,接受贝伐珠单抗 10mg/kg 静脉输注,每 2 周 1 次。主要终点是复发性胶质母细胞瘤患者的 6 个月无进展生存。

结果

31 例患者中,29 例(93.5%)患有胶质母细胞瘤,2 例(6.5%)患有 III 级胶质瘤。基线时有 11 例(35.5%)患者正在使用皮质类固醇;17 例(54.8%)和 14 例(45.2%)患者分别经历过 1 次或 2 次复发。29 例复发性胶质母细胞瘤患者的 6 个月无进展生存率为 33.9%(90%置信区间:19.2-48.5),中位无进展生存期为 3.3 个月。1 年生存率为 34.5%,中位总生存期为 10.5 个月。有 8 例患者(均为部分缓解)客观缓解率为 27.6%。疾病控制率为 79.3%。基线时接受皮质类固醇治疗的 11 例患者中有 8 例减少了剂量或停止了皮质类固醇治疗。贝伐珠单抗的耐受性良好,与贝伐珠单抗相关的 3 级及以上特殊关注不良事件有:高血压[3 例(9.7%)]、充血性心力衰竭[1 例(3.2%)]和静脉血栓栓塞[1 例(3.2%)]。观察到 1 例无症状的 1 级脑出血,未经治疗即可缓解。

结论

贝伐珠单抗单药治疗可为日本复发性胶质母细胞瘤患者带来临床获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a62d/3448378/06afb9599a6c/hys12101.jpg

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