VU University Medical Center, Amsterdam, The Netherlands.
Urology. 2013 Jan;81(1):143-9. doi: 10.1016/j.urology.2012.09.019.
To retrospectively analyze the effects of treatment duration on outcomes of everolimus treatment of patients in the RAD001 Expanded-Access Clinical Trial in RCC (REACT) program.
Patients with metastatic renal cell carcinoma refractory to vascular endothelial growth factor receptor-tyrosine kinase inhibitor received everolimus (10 mg once daily), with dosing interruption or modifications allowed for toxicity. All serious and grade 3/4 adverse events and grade 1/2 adverse events leading to a change in drug administration were reported. Tumor response was evaluated using Response Evaluation Criteria In Solid Tumors.
The study stratified 1367 evaluable patients into treatment duration groups of <3 months, ≥3 and <6 months, ≥6 months and <1 year, and ≥1 year. Pneumonia, noninfectious pneumonitis, and hyperglycemia occurred more frequently in patients receiving everolimus for ≥1 year but did not result in treatment discontinuations. First occurrence of adverse events presented early in the treatment course for most patients. Treatment duration of ≥6 months was associated with improved disease control rates.
Everolimus is well tolerated in patients with metastatic renal cell carcinoma for treatment durations≥1 year and not associated with cumulative toxicity.
回顾性分析 RAD001 扩展准入临床试验(REACT)中接受依维莫司治疗的患者的治疗持续时间对结局的影响。
转移性肾细胞癌患者对血管内皮生长因子受体酪氨酸激酶抑制剂耐药,接受依维莫司(10 mg,每日一次)治疗,允许因毒性而中断或调整剂量。所有严重和 3/4 级不良事件以及导致药物管理改变的 1/2 级不良事件均报告。使用实体瘤反应评估标准评估肿瘤反应。
该研究将 1367 例可评估患者分层为治疗持续时间<3 个月、≥3 个月且<6 个月、≥6 个月且<1 年和≥1 年的组。≥1 年接受依维莫司治疗的患者更常发生肺炎、非传染性肺炎和高血糖,但不会导致治疗中断。大多数患者的不良事件首次发生在治疗早期。治疗持续时间≥6 个月与改善疾病控制率相关。
依维莫司治疗转移性肾细胞癌的治疗持续时间≥1 年,耐受性良好,无累积毒性。