转移性乳腺癌患者中莫特沙尼联合多西他赛或紫杉醇的 1b 期剂量发现研究。

Phase 1b dose-finding study of motesanib with docetaxel or paclitaxel in patients with metastatic breast cancer.

机构信息

Department of Medical Oncology, Royal Melbourne Hospital, Grattan St, 2nd Floor, Parkville, Melbourne, VIC 3050, Australia.

出版信息

Breast Cancer Res Treat. 2012 Aug;135(1):241-52. doi: 10.1007/s10549-012-2135-0. Epub 2012 Jul 29.

Abstract

The purpose of this study was to investigate the safety, tolerability, and pharmacokinetics of motesanib when combined with docetaxel or paclitaxel in patients with metastatic breast cancer. In this open-label, dose-finding, phase 1b study, patients received motesanib 50 or 125-mg orally once daily (QD), beginning day 3 of cycle 1 of chemotherapy, continuously in combination with either paclitaxel 90 mg/m(2) on days 1, 8, and 15 every 28-day cycle (Arm A) or docetaxel 100 mg/m(2) on day 1 every 21-day cycle (Arm B). Dose escalation to motesanib 125 mg QD occurred if the incidence of dose-limiting toxicities (DLTs, primary endpoint) was ≤ 33 %. If the maximum tolerated dose (MTD) of motesanib was established in Arm B, additional patients could receive motesanib at the MTD plus docetaxel 75 mg/m(2). Forty-six patients were enrolled and 45 received ≥ 1 dose of motesanib. The incidence of DLTs was <33 % in all cohorts; thus, motesanib 125 mg QD was established as the MTD. Seven patients (16 %) had grade 3 motesanib-related adverse events including cholecystitis (2 patients) and hypertension (2 patients). Pharmacokinetic parameters of motesanib were similar to those reported in previous studies. The objective response rate was 56 % among patients with measurable disease at baseline who received motesanib in combination with taxane-based chemotherapy. The addition of motesanib to either paclitaxel or docetaxel was generally tolerable up to the 125-mg QD dose of motesanib. The objective response rate of 56 % suggests a potential benefit of motesanib in combination with taxane-based chemotherapy.

摘要

这项研究的目的是探讨在转移性乳腺癌患者中,莫特沙尼联合多西紫杉醇或紫杉醇的安全性、耐受性和药代动力学。在这项开放标签、剂量探索、1b 期研究中,患者接受莫特沙尼 50 或 125mg 每日一次(QD)口服,于化疗第 1 周期第 3 天开始,与紫杉醇 90mg/m(2)联合使用,每 28 天周期的第 1、8 和 15 天(A 组)或与多西紫杉醇 100mg/m(2)联合使用,每 21 天周期的第 1 天(B 组)。如果剂量限制性毒性(DLT,主要终点)的发生率≤33%,则可以增加莫特沙尼的剂量。如果在 B 组确定了莫特沙尼的最大耐受剂量(MTD),则可以在 MTD 的基础上增加多西紫杉醇 75mg/m(2),并让其他患者接受莫特沙尼治疗。共纳入 46 例患者,45 例患者接受了至少 1 剂莫特沙尼治疗。所有队列的 DLT 发生率均<33%;因此,莫特沙尼 125mg QD 被确定为 MTD。7 例患者(16%)出现 3 级莫特沙尼相关不良事件,包括胆囊炎(2 例)和高血压(2 例)。莫特沙尼的药代动力学参数与以前的研究相似。在基线时有可测量疾病的患者中,接受莫特沙尼联合基于紫杉醇的化疗的患者客观缓解率为 56%。莫特沙尼加用紫杉醇或多西紫杉醇均耐受良好,最高剂量可达 125mg QD。56%的客观缓解率提示莫特沙尼联合基于紫杉醇的化疗可能具有潜在获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f31/3413817/83f1cca19816/10549_2012_2135_Fig1_HTML.jpg

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