Yoshino Takayuki, Komatsu Yoshito, Yamada Yasuhide, Yamazaki Kentaro, Tsuji Akihito, Ura Takashi, Grothey Axel, Van Cutsem Eric, Wagner Andrea, Cihon Frank, Hamada Yoko, Ohtsu Atsushi
Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Chiba, Japan,
Invest New Drugs. 2015 Jun;33(3):740-50. doi: 10.1007/s10637-014-0154-x. Epub 2014 Sep 12.
In the international, phase III, randomized, double-blind CORRECT trial, regorafenib significantly prolonged overall survival (OS) versus placebo in patients with metastatic colorectal cancer (mCRC) that had progressed on all standard therapies. This post hoc analysis evaluated the efficacy and safety of regorafenib in Japanese and non-Japanese subpopulations in the CORRECT trial.
Patients were randomized 2 : 1 to regorafenib 160 mg once daily or placebo for weeks 1-3 of each 4-week cycle. The primary endpoint was OS. Outcomes were assessed using descriptive statistics.
One hundred Japanese and 660 non-Japanese patients were randomized to regorafenib (n = 67 and n = 438) or placebo (n = 33 and n = 222). Regorafenib had a consistent OS benefit in the Japanese and non-Japanese subpopulations, with hazard ratios of 0.81 (95 % confidence interval [CI] 0.43-1.51) and 0.77 (95 % CI 0.62-0.94), respectively. Regorafenib-associated hand-foot skin reaction, hypertension, proteinuria, thrombocytopenia, and lipase elevations occurred more frequently in the Japanese subpopulation than in the non-Japanese subpopulation, but were generally manageable.
Regorafenib appears to have comparable efficacy in Japanese and non-Japanese subpopulations, with a manageable adverse-event profile, suggesting that this agent could potentially become a standard of care in patients with mCRC.
在国际III期随机双盲CORRECT试验中,与安慰剂相比,瑞戈非尼显著延长了所有标准治疗均已进展的转移性结直肠癌(mCRC)患者的总生存期(OS)。这项事后分析评估了CORRECT试验中日本和非日本亚组患者使用瑞戈非尼的疗效和安全性。
患者按2:1随机分组,在每4周周期的第1 - 3周接受每日一次160 mg瑞戈非尼或安慰剂治疗。主要终点为总生存期。使用描述性统计评估结果。
100名日本患者和660名非日本患者被随机分配至瑞戈非尼组(n = 67和n = 438)或安慰剂组(n = 33和n = 222)。瑞戈非尼在日本和非日本亚组中均有一致的总生存期获益,风险比分别为0.81(95%置信区间[CI] 0.43 - 1.51)和0.77(95% CI 0.62 - 0.94)。与瑞戈非尼相关的手足皮肤反应、高血压、蛋白尿、血小板减少和脂肪酶升高在日本亚组中比在非日本亚组中更频繁发生,但通常可控制。
瑞戈非尼在日本和非日本亚组中似乎具有相当的疗效,不良事件情况可控,这表明该药物可能成为mCRC患者的一种标准治疗方案。