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一项在铂类耐药或部分铂类敏感复发性卵巢癌女性中联合使用替班尼布与聚乙二醇脂质体阿霉素或拓扑替康的 1b 期研究。

A phase 1b study of trebananib in combination with pegylated liposomal doxorubicin or topotecan in women with recurrent platinum-resistant or partially platinum-sensitive ovarian cancer.

机构信息

University Hospitals Leuven and KU Leuven, Leuven, Belgium.

Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

Gynecol Oncol. 2014 Oct;135(1):25-33. doi: 10.1016/j.ygyno.2014.07.003. Epub 2014 Jul 11.

Abstract

OBJECTIVE

To examine the tolerability and antitumor activity of trebananib plus pegylated liposomal doxorubicin (PLD) or topotecan in recurrent platinum-resistant or partially platinum-sensitive ovarian cancer.

METHODS

In this open-label phase 1b study, patients received trebananib 10 mg/kg or 15 mg/kg IV QW plus PLD 50 mg/m(2) (cohorts A1 and A3, respectively) or topotecan 4 mg/m(2) (cohorts B1 and B3, respectively). Endpoints were dose-limiting toxicity (DLT; primary); treatment-emergent adverse events (AEs), overall response rate, anti-trebananib antibodies, and pharmacokinetics (secondary).

RESULTS

103 patients were enrolled. One patient in A1 and B1 had DLTs. Across all cohorts, the most common AEs were nausea, fatigue, and peripheral edema. Across both trebananib plus PLD cohorts (A1/A3), grade 4 AEs were pulmonary embolism, disease progression, and anemia. Two patients had grade 5 intestinal perforation (n=1) and sudden death (n=1). Across both trebananib plus topotecan cohorts (B1/B3), grade 4 AEs were neutropenia, hypokalemia, decreased granulocyte count, chest pain, dyspnea, decreased neutrophil count, and pulmonary embolism. Two patients had grade 5 disease progression. One patient had grade 5 pleural effusion associated with progressive disease. Confirmed objective response rates were 36.0% (A1), 34.8% (A3), 16.7% (B1), and 0.0% (B3). Median progression-free survival duration (months) was 7.4 (A1), 7.1 (A3), 3.5 (B1), and 3.1 (B3), respectively. No drug-drug interactions were apparent.

CONCLUSIONS

Trebananib 10mg/kg and 15 mg/kg IV QW plus PLD or topotecan appear to have acceptable toxicity profiles in recurrent platinum-resistant or partially platinum-sensitive ovarian cancer. Antitumor activity was evident across all cohorts.

摘要

目的

研究替奈比生联合聚乙二醇脂质体多柔比星(PLD)或拓扑替康治疗铂类耐药或部分铂类敏感复发性卵巢癌的耐受性和抗肿瘤活性。

方法

这是一项开放标签的 1b 期研究,患者接受替奈比生 10mg/kg 或 15mg/kg,静脉注射,每周一次(A1 和 A3 组),或联合 PLD 50mg/m2 ;或拓扑替康 4mg/m2(B1 和 B3 组)。主要终点为剂量限制性毒性(DLT);次要终点为治疗中出现的不良事件(AE)、总缓解率、抗替奈比生抗体和药代动力学。

结果

共纳入 103 例患者。A1 组和 B1 组各有 1 例患者发生 DLT。所有队列中,最常见的 AE 为恶心、乏力和外周水肿。在替奈比生联合 PLD 两个队列(A1/A3)中,4 级 AE 为肺栓塞、疾病进展和贫血。2 例患者发生 5 级肠穿孔(1 例)和猝死(1 例)。在替奈比生联合拓扑替康两个队列(B1/B3)中,4 级 AE 为中性粒细胞减少、低钾血症、粒细胞计数减少、胸痛、呼吸困难、中性粒细胞减少和肺栓塞。2 例患者发生 5 级疾病进展。1 例患者发生与疾病进展相关的 5 级胸腔积液。A1 组、A3 组、B1 组和 B3 组的客观缓解率分别为 36.0%、34.8%、16.7%和 0.0%。中位无进展生存期(月)分别为 7.4(A1)、7.1(A3)、3.5(B1)和 3.1(B3)。未见药物-药物相互作用。

结论

替奈比生 10mg/kg 和 15mg/kg 静脉注射,每周一次,联合 PLD 或拓扑替康治疗铂类耐药或部分铂类敏感复发性卵巢癌,毒性谱可接受。所有队列均显示抗肿瘤活性。

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