Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, China.
Radiother Oncol. 2013 Nov;109(2):275-80. doi: 10.1016/j.radonc.2013.09.008. Epub 2013 Oct 12.
This multicenter phase II trial investigated cetuximab combined with chemoradiotherapy in patients with esophageal squamous cell carcinoma (ESCC).
Eligible patients with non-resectable, locally-advanced ESCC received cetuximab 400mg/m(2) loading dose on day 1; and on day 1 of the 2nd-7th weeks: cetuximab 250mg/m(2), paclitaxel 45mg/m(2), and cisplatin 20mg/m(2), concurrent with 59.4Gy/33 fractions of radiation therapy. Primary endpoint was clinical response rate. Secondary endpoints included overall survival (OS), progression-free survival (PFS), safety, and KRAS status.
Of 55 patients enrolled, 45 completed therapy. Forty-four patients had a clinical response: 29 complete response and 15 partial response. One-year PFS and OS of 45 evaluable patients were 84.23% and 93.33%, respectively, and 2-year PFS and OS were 74.87% and 80.00%, respectively. Non-hematologic adverse events were generally grade 1 or 2; primarily rash (92.7%), mucositis (45.5%), fatigue (41.8%), and nausea (38.2%). Grade 3 hematologic adverse events included neutropenia (32.7%) and anemia (1.8%). No KRAS mutations were identified in 50 evaluated samples.
Cetuximab can be safely administered with chemoradiotherapy to patients with locally-advanced ESCC and may improve clinical response rate.
本多中心 II 期临床试验旨在研究西妥昔单抗联合放化疗治疗食管鳞癌(ESCC)。
纳入的不可切除、局部晚期 ESCC 患者接受西妥昔单抗 400mg/m²负荷剂量,第 1 天;第 2-7 周第 1 天:西妥昔单抗 250mg/m²,紫杉醇 45mg/m²,顺铂 20mg/m²,同时接受 59.4Gy/33 次放疗。主要终点为临床缓解率。次要终点包括总生存期(OS)、无进展生存期(PFS)、安全性和 KRAS 状态。
55 例患者中,45 例完成治疗。44 例患者有临床缓解:29 例完全缓解,15 例部分缓解。45 例可评估患者的 1 年 PFS 和 OS 分别为 84.23%和 93.33%,2 年 PFS 和 OS 分别为 74.87%和 80.00%。非血液学不良事件一般为 1 级或 2 级;主要为皮疹(92.7%)、黏膜炎(45.5%)、乏力(41.8%)和恶心(38.2%)。3 级血液学不良事件包括中性粒细胞减少(32.7%)和贫血(1.8%)。50 例评估样本中未发现 KRAS 突变。
西妥昔单抗联合放化疗治疗局部晚期 ESCC 安全有效,可能提高临床缓解率。