Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Cancer. 2015 Aug 1;121(15):2612-7. doi: 10.1002/cncr.29401. Epub 2015 Apr 22.
The objective of this study was to evaluate the efficacy and safety of dovitinib in patients with adenoid cystic carcinoma (ACC).
ACC patients with documented disease progression within the past 12 months were eligible. Patients received oral dovitinib (500 mg once daily for 5 consecutive days followed by a 2-day rest every week) until disease progression or unacceptable toxicities. The primary endpoint was the probability of 4-month progression-free survival (PFS). Metabolic response was evaluated with positron emission tomography (PET)/computed tomography (CT) scans performed at the baseline and after 8 weeks of treatment.
Between September 2011 and April 2013, 32 patients with metastatic and/or unresectable ACC were enrolled in this prospective, multicenter trial. The 4-month PFS probability was 80.4%, and the median PFS was 6.0 months (95% confidence interval, 4.4-7.6 months). Tumor shrinkage was observed in 22 patients (68.8%), and 1 patient had a confirmed partial response. The disease control rate was 96.9%. Among 26 patients with PET/CT scans both before and after treatment (at 8 weeks), the metabolic activity of ACC was reduced in 13 patients (50.0%), and 5 patients (19.2%) achieved a metabolic partial response, which was defined as a ≥25% reduction in maximum standardized uptake values. Common grade 3 and 4 adverse events were asthenia (50.0%) and neutropenia (25.0%).
Dovitinib shows modest antitumor activity in the treatment of ACC.
本研究旨在评估多韦替尼在腺样囊性癌(ACC)患者中的疗效和安全性。
本研究纳入了过去 12 个月内有疾病进展记录的 ACC 患者。患者接受口服多韦替尼(500mg,每日一次,连续 5 天,然后每周休息 2 天)治疗,直至疾病进展或出现不可耐受的毒性。主要终点为 4 个月无进展生存期(PFS)的概率。采用基线和治疗 8 周后进行的正电子发射断层扫描(PET)/计算机断层扫描(CT)评估代谢反应。
2011 年 9 月至 2013 年 4 月,共有 32 例转移性和/或不可切除的 ACC 患者入组了本前瞻性、多中心试验。4 个月 PFS 概率为 80.4%,中位 PFS 为 6.0 个月(95%置信区间,4.4-7.6 个月)。22 例患者(68.8%)观察到肿瘤缩小,1 例患者有确认的部分缓解。疾病控制率为 96.9%。在 26 例治疗前后均进行了 PET/CT 扫描的患者中(在 8 周时),13 例(50.0%)患者的 ACC 代谢活性降低,5 例(19.2%)患者获得了代谢部分缓解,定义为最大标准化摄取值降低≥25%。常见的 3 级和 4 级不良事件为乏力(50.0%)和中性粒细胞减少(25.0%)。
多韦替尼在治疗 ACC 方面具有适度的抗肿瘤活性。