Cardiology Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Bichat, Paris, France,
Cancer Chemother Pharmacol. 2014 Jun;73(6):1241-52. doi: 10.1007/s00280-014-2460-6. Epub 2014 Apr 10.
This study assessed the cardiovascular safety of cabazitaxel, based on thorough evaluation of QT and non-QT variables, and the relationship between pharmacokinetic and pharmacodynamic electrocardiographic (ECG) profiles and the occurrence of Grade ≥3 cardiovascular adverse events.
Patients with advanced solid tumors were treated with cabazitaxel 25 mg/m(2) every 3 weeks. Digital ECG recordings were obtained during Cycle 1 over 24 h after dosing. The primary end point was effect of cabazitaxel on QT interval corrected by the Fridericia formula (QTcF). Secondary end points were additional ECG parameters (QT, PR and QRS intervals, and heart rate), plasma pharmacokinetics of cabazitaxel and overall clinical safety.
The pharmacodynamic (ECG) population included 94 patients. In 63 patients with a full 24-h ECG evaluation, the maximum upper bound of 90 % confidence interval (CI) for mean QTcF change from baseline was 7.46 ms (mean 4.8 ms), occurring at 1 h 30 min post-infusion. The slope of QTcF change from baseline versus cabazitaxel concentration was slightly negative (-0.012 [95 % CI -0.017; -0.008], equivalent to a 1.2 ms decrease per 100 ng/mL increase in cabazitaxel concentration). For non-QT variables, no effect was noted. No Grade ≥3 cardiac adverse events were observed; Grade ≥3 hypotension and lymphocele occurred in two patients and one patient, respectively.
These results suggest that cabazitaxel has no clinically significant cardiovascular adverse effects in patients with advanced solid tumors.
本研究通过全面评估 QT 和非 QT 变量,以及药代动力学和药效学心电图(ECG)特征与发生≥3 级心血管不良事件之间的关系,评估卡巴他赛的心血管安全性。
晚期实体瘤患者接受卡巴他赛 25 mg/m2 治疗,每 3 周一次。在第 1 周期给药后 24 小时内进行数字 ECG 记录。主要终点为卡巴他赛对 Fridericia 公式校正的 QT 间期(QTcF)的影响。次要终点为其他 ECG 参数(QT、PR 和 QRS 间期以及心率)、卡巴他赛的血浆药代动力学和总体临床安全性。
药效学(ECG)人群包括 94 例患者。在 63 例有完整 24 小时 ECG 评估的患者中,平均 QTcF 从基线的最大上限 90%置信区间(CI)为 7.46 ms(平均 4.8 ms),发生在输注后 1 小时 30 分钟。QTcF 从基线的变化斜率与卡巴他赛浓度呈轻微负相关(-0.012 [95%CI -0.017;-0.008],相当于卡巴他赛浓度每增加 100 ng/mL,QTcF 降低 1.2 ms)。对于非 QT 变量,没有观察到影响。未观察到≥3 级心脏不良事件;两名患者分别发生了≥3 级低血压和淋巴囊肿,一名患者发生了 1 级低血压。
这些结果表明,卡巴他赛在晚期实体瘤患者中没有明显的心血管不良作用。