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萨拉卡替尼(AZD0530)用于既往接受过治疗的转移性结直肠癌患者的II期研究。

Phase II study of saracatinib (AZD0530) in patients with previously treated metastatic colorectal cancer.

作者信息

Reddy S M, Kopetz S, Morris J, Parikh N, Qiao W, Overman M J, Fogelman D, Shureiqi I, Jacobs C, Malik Z, Jimenez C A, Wolff R A, Abbruzzese J L, Gallick G, Eng C

机构信息

Hematology-Oncology Fellow, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 463, Houston, TX, 77030, USA,

出版信息

Invest New Drugs. 2015 Aug;33(4):977-84. doi: 10.1007/s10637-015-0257-z. Epub 2015 Jun 12.

Abstract

BACKGROUND

Src has a critical role in tumor cell migration and invasion. Increased Src activity has been shown to correlate with disease progression and poor prognosis, suggesting Src could serve as a therapeutic target for kinase inhibition. Saracatinib (AZD0530) is a novel selective oral Src kinase inhibitor.

METHODS

Metastatic colorectal cancer patients who had received one prior treatment and had measurable disease were enrolled in this phase 2 study. Saracatinib was administered at 175 mg by mouth daily for 28 day cycles until dose-limiting toxicity or progression as determined by staging every 2 cycles. The primary endpoint was improvement in 4 month progression-free survival. Design of Thall, Simon, and Estey was used to monitor proportion of patients that were progression free at 4 months. The trial was opened with plan to enroll maximum of 35 patients, with futility assessment every 10 patients.

RESULTS

A total of 10 patients were enrolled between January and November 2007. Further enrollment was stopped due to futility. Median progression-free survival was 7.9 weeks, with all 10 patients showing disease progression following radiographic imaging. Median overall survival was 13.5 months. All patients were deceased by time of analysis. Observed adverse events were notable for a higher than expected number of patients with grade 3 hypophosphatemia (n = 5).

CONCLUSION

Saracatinib is a novel oral Src kinase inhibitor that was well tolerated but failed to meet its primary endpoint of improvement in 4 month progression-free survival as a single agent in previously treated metastatic colorectal cancer patients.

摘要

背景

Src在肿瘤细胞迁移和侵袭中起关键作用。已表明Src活性增加与疾病进展和不良预后相关,这表明Src可作为激酶抑制的治疗靶点。萨拉卡替尼(AZD0530)是一种新型选择性口服Src激酶抑制剂。

方法

入组本2期研究的是接受过一次先前治疗且有可测量病灶的转移性结直肠癌患者。萨拉卡替尼按每日175mg口服给药,每28天为一个周期,直至出现剂量限制性毒性或每2个周期分期确定的病情进展。主要终点是4个月无进展生存期的改善。采用Thall、Simon和Estey设计来监测4个月时无进展患者的比例。该试验开始时计划最多招募35名患者,每10名患者进行一次无效性评估。

结果

2007年1月至11月共入组10例患者。由于无效性,停止进一步入组。中位无进展生存期为7.9周,经影像学检查,所有10例患者均出现疾病进展。中位总生存期为13.5个月。至分析时所有患者均死亡。观察到的不良事件中,3级低磷血症患者数量高于预期(n = 5)。

结论

萨拉卡替尼是一种新型口服Src激酶抑制剂,耐受性良好,但作为单药用于先前治疗的转移性结直肠癌患者时,未能达到其4个月无进展生存期改善的主要终点。

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