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奥沙利铂、多西他赛和贝伐珠单抗一线治疗卵巢、腹膜和输卵管晚期癌症的 II 期临床试验。

A phase II trial of oxaliplatin, docetaxel, and bevacizumab as first-line therapy of advanced cancer of the ovary, peritoneum, and fallopian tube.

机构信息

Columbia University, NY Presbyterian Medical Center, New York, NY, USA.

Creighton University School of Medicine, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.

出版信息

Gynecol Oncol. 2014 Mar;132(3):517-25. doi: 10.1016/j.ygyno.2014.01.035. Epub 2014 Jan 27.

Abstract

OBJECTIVE

To determine the safety and efficacy of the novel combination of docetaxel, oxaliplatin, and bevacizumab as first-line treatment of advanced cancer of the ovary, peritoneum or fallopian tube after initial debulking surgery.

METHODS

Eligible patients (stage IB-IV) were treated with 6 cycles of oxaliplatin (85 mg/m(2)), docetaxel (75 mg/m(2)), and bevacizumab (15 mg/kg) every 3 weeks, followed by single-agent bevacizumab 15 mg/kg every 3 weeks to complete one year of therapy. The primary endpoint was 12-month progression-free survival (PFS).

RESULTS

A total of 132 patients (80 with measurable disease at baseline; 52 with non-measurable, evaluable disease at baseline) enrolled and received study treatment. At diagnosis, 76.5% of patients had stage III disease and 20% had stage IV. 62.9% were optimally cytoreduced. The most common grade 3/4 adverse events were neutropenia (42.4%), leukopenia (13.6%), hypertension (8.3%), fatigue (6.1%), and nausea (6.1%). One patient (0.8%) had a fatal gastrointestinal perforation. The best overall confirmed response rate (complete response+partial response [measurable disease subgroup]) was 58.6% (95% CI 49%, 67%). CA-125 response rates for the measurable and non-measurable disease subgroups were 83.0% and 81.5%, respectively. The 12-month PFS rate for the measurable disease subgroup was 65.7% (95% CI 53.4%, 76.7%); median PFS was 16.3 (95% CI 12.6, 19.6) months. Median overall survival was 47.3 (95% CI 34.1, upper limit not applicable) months.

CONCLUSIONS

This novel treatment regimen may provide a promising therapeutic approach for women with ovarian, primary peritoneal, or fallopian tube carcinoma. No unanticipated safety concerns were identified.

摘要

目的

评估多西他赛、奥沙利铂和贝伐珠单抗联合方案作为初始肿瘤细胞减灭术治疗后的晚期卵巢癌、腹膜癌或输卵管癌一线治疗的安全性和有效性。

方法

入组患者(IB-IV 期)接受 6 个周期的奥沙利铂(85mg/m2)、多西他赛(75mg/m2)和贝伐珠单抗(15mg/kg)治疗,每 3 周 1 次,随后单药贝伐珠单抗 15mg/kg 每 3 周 1 次,完成 1 年的治疗。主要终点为 12 个月无进展生存期(PFS)。

结果

共 132 例患者(基线时 80 例有可测量病灶;52 例基线时无可测量病灶,但有可评估病灶)入组并接受了研究治疗。诊断时,76.5%的患者为 III 期疾病,20%的患者为 IV 期疾病。62.9%的患者实现了最佳肿瘤细胞减灭。最常见的 3/4 级不良事件为中性粒细胞减少症(42.4%)、白细胞减少症(13.6%)、高血压(8.3%)、疲劳(6.1%)和恶心(6.1%)。1 例患者(0.8%)发生致命性胃肠道穿孔。在可测量疾病亚组中,最佳总确认缓解率(完全缓解+部分缓解)为 58.6%(95%CI,49%,67%)。可测量和不可测量疾病亚组的 CA-125 缓解率分别为 83.0%和 81.5%。可测量疾病亚组的 12 个月 PFS 率为 65.7%(95%CI,53.4%,76.7%);中位 PFS 为 16.3 个月(95%CI,12.6,19.6)。中位总生存期为 47.3 个月(95%CI,34.1,未达到上限)。

结论

这种新的治疗方案可能为卵巢癌、原发性腹膜癌或输卵管癌患者提供一种有前景的治疗方法。未发现意外的安全性问题。

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