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尼达尼布(BIBF 1120)联合多西他赛治疗既往治疗的非小细胞肺癌日本患者的耐受性:1 期研究。

Tolerability of nintedanib (BIBF 1120) in combination with docetaxel: a phase 1 study in Japanese patients with previously treated non-small-cell lung cancer.

机构信息

*Department of Medical Oncology, Kinki University Faculty of Medicine, Osaka, Japan; †Center for Clinical and Translational Research, Faculty of Medicine, Kyusyu University Hospital, Fukuoka, Japan; ‡Department of Internal Medicine, Suita Municipal Hospital, Osaka, Japan; §Department of Medical Oncology, Nara Hospital, Kinki University Faculty of Medicine, Nara, Japan; ║Department of Medicine, Division of Respirology, Neurology, and Rheumatology, Kurume University Hospital, Fukuoka, Japan; ¶Department of Medical Oncology, Kishiwada Municipal Hospital, Osaka, Japan; #Department of Thoracic Oncology, Kansai Medical University, Hirakata Hospital, Osaka, Japan; **Department of Medical Oncology, National Kyushu Cancer Centre, Fukuoka, Japan; ††Department of Medical Oncology, National Kyushu Cancer Centre, Fukuoka, Japan; ‡‡Nippon Boehringer Ingelheim Co. Ltd., Medical Development Division, Hyogo, Japan; and §§Clinical Pharmacokinetics/Pharmacodynamics Department, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany.

出版信息

J Thorac Oncol. 2015 Feb;10(2):346-52. doi: 10.1097/JTO.0000000000000395.

Abstract

BACKGROUND

This phase I, open-label study evaluated the safety/tolerability and maximum tolerated dose of second-line nintedanib combined with docetaxel in Japanese patients with advanced non-small-cell lung cancer.

METHODS

Eligible patients received docetaxel 60 or 75 mg/m(2) (day 1) plus nintedanib 100, 150, or 200 mg twice daily (bid; days 2-21) in 21-day cycles. Standard 3 + 3 dose escalations were performed separately in patient cohorts with a body surface area (BSA) of less than 1.5 m(2) (BSA <1.5) and BSA greater than or equal to 1.5, respectively.

RESULTS

Forty-two patients (17 BSA <1.5, 25 BSA ≥ 1.5) were treated. The maximum tolerated dose of nintedanib was 150 and 200 mg bid in patients with BSA less than 1.5 and BSA greater than or equal to 1.5 (BSA ≥ 1.5), respectively, in combination with 75 mg/m(2) of docetaxel. Dose-limiting toxicities (all grade 3 hepatic enzyme elevations) occurred in 12 patients (six per cohort). Drug-related adverse events included neutropenia (95%), leukopenia (83%), fatigue (76%), alopecia (71%), decreased appetite (67%), and elevations in alanine aminotransferase (64%) and aspartate aminotransferase (64%). All hepatic enzyme elevations were reversible and manageable with dose reduction or discontinuation. Among 38 evaluable patients, 10 (26%) had a partial response and 18 (47%) had stable disease.

CONCLUSION

Continuous treatment with second-line nintedanib combined with docetaxel was manageable and showed promising signs of efficacy in Japanese patients with advanced non-small-cell lung cancer.

摘要

背景

这项 I 期、开放标签研究评估了二线尼达尼布联合多西他赛在日本晚期非小细胞肺癌患者中的安全性/耐受性和最大耐受剂量。

方法

符合条件的患者接受多西他赛 60 或 75mg/m²(第 1 天)联合尼达尼布 100、150 或 200mg 每日两次(第 2-21 天)治疗,每 21 天为一个周期。分别在体表面积(BSA)小于 1.5m²(BSA<1.5)和 BSA 大于或等于 1.5 的患者队列中进行标准的 3+3 剂量递增。

结果

42 例患者(BSA<1.5 17 例,BSA≥1.5 25 例)接受了治疗。尼达尼布的最大耐受剂量分别为 BSA<1.5 患者的 150mg bid 和 BSA≥1.5 患者的 200mg bid,联合使用 75mg/m²的多西他赛。12 例患者(每个队列 6 例)出现剂量限制性毒性(均为 3 级肝酶升高)。药物相关不良反应包括中性粒细胞减少(95%)、白细胞减少(83%)、疲劳(76%)、脱发(71%)、食欲下降(67%)和丙氨酸氨基转移酶(64%)和天冬氨酸氨基转移酶(64%)升高。所有肝酶升高均为可逆性,可通过减少剂量或停药来控制。在 38 例可评估患者中,10 例(26%)有部分缓解,18 例(47%)病情稳定。

结论

二线尼达尼布联合多西他赛的持续治疗是可控的,在日本晚期非小细胞肺癌患者中显示出有希望的疗效迹象。

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