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尼妥珠单抗联合化疗对比单纯化疗治疗晚期非小细胞肺癌的多中心、随机、开放标签的 II 期研究。

Nimotuzumab plus chemotherapy versus chemotherapy alone in advanced non-small-cell lung cancer: a multicenter, randomized, open-label Phase II study.

机构信息

Kidwai Memorial Institute of Oncology, Bangalore, India.

Tata Memorial Hospital, Mumbai, India.

出版信息

Onco Targets Ther. 2014 Jun 13;7:1051-60. doi: 10.2147/OTT.S63168. eCollection 2014.

Abstract

BACKGROUND

The purpose of this study was to evaluate the safety and efficacy of nimotuzumab in combination with chemotherapy (docetaxel and carboplatin) versus chemotherapy alone in patients with stage IIIB/IV non-small-cell lung cancer.

METHODS

This multicenter, open-label, Phase II study randomized 110 patients to receive nimotuzumab plus chemotherapy (nimotuzumab group) or chemotherapy alone (control group), and comprised concomitant, maintenance, and follow-up phases. Nimotuzumab 200 mg was administered once weekly for 13 weeks during the first two phases with four cycles of chemotherapy and docetaxel 75 mg/m(2) and carboplatin (area under the curve 5 mg/mL*min) every 3 weeks for a maximum of four cycles during the concomitant phase. The primary endpoint was objective response rate (sum of complete response and partial response). Secondary endpoints, ie, overall survival and progression-free survival, were estimated using the Kaplan-Meier method. Efficacy was evaluated on the intent-to-treat and efficacy-evaluable sets. Safety was assessed from adverse event and serious adverse event data.

RESULTS

The objective response rate was significantly higher in the nimotuzumab group than in the control group in the intent-to-treat population (54% versus 34.5%; P=0.04). A complete response and partial response were achieved in 3.6% and 50% of patients, respectively, in the nimotuzumab group, and in 4% and 30.9% of patients, respectively, in the control group. No significant differences in median progression-free survival and overall survival were observed. Safety profiles were comparable between the two groups.

CONCLUSION

Nimotuzumab plus chemotherapy significantly improved the objective response rate as compared with chemotherapy alone. The combination was safe and well tolerated in patients with stage IIIB/IV non-small-cell lung cancer.

摘要

背景

本研究旨在评估尼妥珠单抗联合化疗(多西他赛和卡铂)与单纯化疗相比,在 IIIB/IV 期非小细胞肺癌患者中的安全性和有效性。

方法

这是一项多中心、开放性、II 期研究,将 110 例患者随机分为尼妥珠单抗联合化疗组(尼妥珠单抗组)和单纯化疗组(对照组),包括同时期、维持期和随访期。在同时期,尼妥珠单抗组在第一和第二期,每 2 周给予尼妥珠单抗 200mg 治疗,共 13 周,联合 4 个周期的化疗(多西他赛 75mg/m2,卡铂[曲线下面积 5mg/mL*min]);在维持期,每 3 周给予尼妥珠单抗 200mg 治疗,共 4 个周期。主要终点为客观缓解率(完全缓解+部分缓解的总和)。次要终点,即总生存期和无进展生存期,采用 Kaplan-Meier 法估计。疗效根据意向治疗和疗效可评价人群评估。安全性根据不良事件和严重不良事件数据评估。

结果

在意向治疗人群中,尼妥珠单抗组的客观缓解率显著高于对照组(54%比 34.5%;P=0.04)。尼妥珠单抗组分别有 3.6%和 50%的患者达到完全缓解和部分缓解,对照组分别有 4%和 30.9%的患者达到完全缓解和部分缓解。无进展生存期和总生存期的中位数无显著差异。两组安全性特征相似。

结论

与单纯化疗相比,尼妥珠单抗联合化疗显著提高了客观缓解率。该联合方案在 IIIB/IV 期非小细胞肺癌患者中安全且耐受良好。

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