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阿昔替尼联合铂类双药治疗晚期非小细胞肺癌及其他实体瘤的 I 期临床试验。

Phase I trial of axitinib combined with platinum doublets in patients with advanced non-small cell lung cancer and other solid tumours.

机构信息

Section of Oncology/Hematology, Ingalls Hospital, Harvey, IL, USA.

出版信息

Br J Cancer. 2012 Oct 9;107(8):1277-85. doi: 10.1038/bjc.2012.406. Epub 2012 Sep 18.

Abstract

BACKGROUND

This phase I dose-finding trial evaluated safety, efficacy and pharmacokinetics of axitinib, a potent and selective second-generation inhibitor of vascular endothelial growth factor receptors, combined with platinum doublets in patients with advanced non-small cell lung cancer (NSCLC) and other solid tumours.

METHODS

In all, 49 patients received axitinib 5 mg twice daily (b.i.d.) with paclitaxel/carboplatin or gemcitabine/cisplatin in 3-week cycles. Following determination of the maximum tolerated dose, a squamous cell NSCLC expansion cohort was enroled and received axitinib 5 mg b.i.d. with paclitaxel/carboplatin.

RESULTS

Two patients experienced dose-limiting toxicities: febrile neutropenia (n=1) in the paclitaxel/carboplatin cohort and fatigue (n=1) in the gemcitabine/cisplatin cohort. Common nonhaematologic treatment-related adverse events were hypertension (36.7%), diarrhoea (34.7%) and fatigue (28.6%). No grade ≥3 haemoptysis occurred among 12 patients with squamous cell NSCLC. The objective response rate was 37.0% for patients receiving axitinib/paclitaxel/carboplatin (n=27) and 23.8% for patients receiving axitinib/gemcitabine/cisplatin (n=21). Pharmacokinetics of axitinib and chemotherapeutic agents were similar when administered alone or in combination.

CONCLUSION

Axitinib 5 mg b.i.d. may be combined with standard paclitaxel/carboplatin or gemcitabine/cisplatin regimens without evidence of overt drug-drug interactions. Both combinations demonstrated clinical efficacy and were well tolerated.

摘要

背景

本 I 期剂量探索试验评估了阿昔替尼(一种强效、选择性的第二代血管内皮生长因子受体抑制剂)联合铂类双药化疗治疗晚期非小细胞肺癌(NSCLC)和其他实体瘤患者的安全性、疗效和药代动力学。

方法

共 49 例患者接受阿昔替尼 5mg,每日两次(bid),联合紫杉醇/卡铂或吉西他滨/顺铂,每 3 周为一个周期。在确定最大耐受剂量后,招募了鳞癌 NSCLC 扩展队列,并接受阿昔替尼 5mg,bid,联合紫杉醇/卡铂。

结果

2 例患者发生剂量限制性毒性:紫杉醇/卡铂组发热性中性粒细胞减少(n=1),吉西他滨/顺铂组疲劳(n=1)。常见的非血液学治疗相关不良反应包括高血压(36.7%)、腹泻(34.7%)和疲劳(28.6%)。12 例鳞癌患者中无≥3 级咯血。阿昔替尼/紫杉醇/卡铂组(n=27)的客观缓解率为 37.0%,阿昔替尼/吉西他滨/顺铂组(n=21)为 23.8%。阿昔替尼单独或联合应用时,其药代动力学与化疗药物相似。

结论

阿昔替尼 5mg,bid,联合标准紫杉醇/卡铂或吉西他滨/顺铂方案治疗,无明显药物相互作用。两种联合方案均显示出临床疗效且耐受良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1752/3494447/88a8fa3f3710/bjc2012406f1.jpg

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