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一项在先前基于铂类化疗后 12 个月内复发的卵巢癌中使用多西他赛和贝伐珠单抗的 II 期临床试验。

A phase II trial of docetaxel and bevacizumab in recurrent ovarian cancer within 12 months of prior platinum-based chemotherapy.

机构信息

H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA.

出版信息

Gynecol Oncol. 2013 Jul;130(1):19-24. doi: 10.1016/j.ygyno.2013.04.049. Epub 2013 Apr 25.

Abstract

OBJECTIVES

The efficacy and safety of bevacizumab and docetaxel were evaluated in women who developed recurrent epithelial ovarian, fallopian, or peritoneal cancer within 12 months of platinum-based therapy.

METHODS

Patients received docetaxel (40 mg/m(2)) on days 1 and 8 and bevacizumab (15 mg/kg) on day 1 of a 21-daycycle. Primary endpoint was 6-month progression-free survival (PFS).

RESULTS

Forty-one patients were evaluable for PFS and 38 for best response; 46% had platinum-free intervals (PFI) of <6 months and 54% between 6 and 12 months. The 6-month PFS was 43.9% (95% confidence interval (CI(95%))=28.6-58.2%). Median PFS (months) was 5.2 (CI(95%)=4.4-7.2) for all patients, 6.2 (CI(95%)=4.1-7.4) for patients with PFI <6 months, and 5.1 (CI(95%)=3.0-7.2) for those with PFI ≥ 6 months. Twenty-two patients showed overall response (CR+PR) (57.9%; CI(95%)=40.8-73.7%), and 32 showed clinical benefit (CR+PR+SD) (84.2%; CI(95%)=68.8-94.0%). For those with complete or partial responses, median duration of response was 4.8 months (0.7-14.5). Median overall survival was 12.4 months (CI(95%)=10.0-21.9). The most common grade 3/4 adverse events (AEs) were neutropenia (14.6% of patients), followed by leukopenia, fatigue, metabolic, and gastrointestinal, with 66% showing any grade 3/4 toxicity. Most common AEs of any grade were gastrointestinal (93%), fatigue (73%), and pain (73%). Four (10%) patients developed hypertension, 1 a gastrointestinal perforation, and another a colovesicular fistula.

CONCLUSIONS

Bevacizumab and docetaxel administered in patients with recurrent ovarian cancer is an active regimen without new unanticipated toxicities. This combination should be an option for further study or clinical use in recurrent ovarian cancer.

摘要

目的

评价贝伐单抗联合多西紫杉醇治疗上皮性卵巢癌、输卵管癌或腹膜癌患者铂类化疗后 12 个月内复发的疗效和安全性。

方法

患者接受多西紫杉醇(40mg/m²)第 1、8 天,贝伐单抗(15mg/kg)第 1 天,21 天为 1 个周期。主要终点为 6 个月无进展生存(PFS)。

结果

41 例患者可评估 PFS,38 例患者可评估最佳缓解情况;46%患者无铂间期(PFI)<6 个月,54%患者 PFI 为 6-12 个月。6 个月 PFS 为 43.9%(95%置信区间[95%CI]为 28.6%-58.2%)。所有患者的中位 PFS(月)为 5.2(95%CI=4.4-7.2),PFI<6 个月患者为 6.2(95%CI=4.1-7.4),PFI≥6 个月患者为 5.1(95%CI=3.0-7.2)。22 例患者(57.9%;95%CI=40.8%-73.7%)显示总体缓解(CR+PR),32 例患者(84.2%;95%CI=68.8%-94.0%)显示临床获益(CR+PR+SD)。对于完全或部分缓解患者,中位缓解持续时间为 4.8 个月(0.7-14.5)。中位总生存时间为 12.4 个月(95%CI=10.0-21.9)。最常见的 3/4 级不良事件(AE)为中性粒细胞减少(14.6%的患者),其次为白细胞减少、疲劳、代谢和胃肠道事件,66%的患者出现任何 3/4 级毒性。最常见的任何级别 AE 为胃肠道(93%)、疲劳(73%)和疼痛(73%)。4 例(10%)患者发生高血压,1 例患者发生胃肠道穿孔,另 1 例发生结肠-膀胱瘘。

结论

贝伐单抗联合多西紫杉醇治疗复发性卵巢癌是一种有效的方案,无新的意外毒性。该联合方案可能是复发性卵巢癌进一步研究或临床应用的选择。

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