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克唑替尼治疗中国患者ALK阳性晚期非小细胞肺癌的疗效和耐受性

Efficacy and tolerability of crizotinib in the treatment of ALK-positive, advanced non-small cell lung cancer in Chinese patients.

作者信息

Cui Shaohua, Zhao Yizhuo, Gu Aiqin, Ge Xiaoxiao, Song Yanyan, Zhang Wei, Lou Yuqing, Dong Lili, Han Baohui, Jiang Liyan

机构信息

Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241# Huaihai (W.) Rd, Shanghai, China.

出版信息

Med Oncol. 2015 Jun;32(6):626. doi: 10.1007/s12032-015-0626-7. Epub 2015 May 13.

Abstract

Crizotinib has been reported to be particularly effective and to have acceptable toxicity in advanced anaplastic lymphoma kinase (ALK)-positive, non-small cell lung cancer (NSCLC). In this study, we analyzed the efficacy and tolerability of crizotinib in the treatment of 72 Chinese patients with ALK-positive, advanced NSCLC. All patients received oral crizotinib 250 mg twice daily in 28-day cycles during the period June 1, 2013, to October 15, 2014. The tumor response was assessed after the first cycle of crizotinib and then after every two cycles using the Response Evaluation Criteria in Solid Tumors (RECIST), version 1.0. Tolerability was assessed at least twice per cycle until crizotinib was discontinued. The patients tended to be young (mean age 55 years, range 31-83 years), never or light smokers (smoking index <400), and to have an adenocarcinoma histology. Most (49/72; 68.1 %) had received previous anticancer treatment before crizotinib therapy. Sixty-seven patients (93 %) were able to be assessed for efficacy. The objective response rate and disease control rate were 52.2 % (95 % CI 40.5-63.9 %) and 64.2 % (95 % CI 52.75-75.7 %), respectively. The estimated median progression-free survival for all 67 patients was 10.3 months (95 % CI 8.6-12.0 months). Mild visual disturbances, nausea, vomiting, diarrhea and constipation were the most commonly reported adverse effects. Thus, crizotinib was well tolerated and showed promising efficacy in Chinese patients with ALK-positive, advanced NSCLC. Further prospective, multicenter studies with a larger sample size are needed to confirm these findings.

摘要

据报道,克唑替尼对晚期间变性淋巴瘤激酶(ALK)阳性的非小细胞肺癌(NSCLC)特别有效且毒性可接受。在本研究中,我们分析了克唑替尼治疗72例中国ALK阳性晚期NSCLC患者的疗效和耐受性。所有患者在2013年6月1日至2014年10月15日期间,接受口服克唑替尼250mg,每日两次,每28天为一个周期。在克唑替尼的第一个周期后,然后每两个周期使用实体瘤疗效评价标准(RECIST)1.0版评估肿瘤反应。在克唑替尼停药前,每个周期至少评估两次耐受性。患者往往较年轻(平均年龄55岁,范围31 - 83岁),从不吸烟或轻度吸烟(吸烟指数<400),且组织学类型为腺癌。大多数(49/72;68.1%)患者在克唑替尼治疗前接受过先前的抗癌治疗。67例患者(93%)能够进行疗效评估。客观缓解率和疾病控制率分别为52.2%(95%CI 40.5 - 63.9%)和64.2%(95%CI 52.75 - 75.7%)。所有67例患者的估计无进展生存期为10.3个月(95%CI 8.6 - 12.0个月)。轻度视觉障碍、恶心、呕吐、腹泻和便秘是最常报告的不良反应。因此,克唑替尼在中国ALK阳性晚期NSCLC患者中耐受性良好且显示出有前景的疗效。需要进一步进行更大样本量的前瞻性多中心研究来证实这些发现。

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