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索拉非尼的疗效与中国转移性肾细胞癌患者的纪念斯隆凯特琳癌症中心(MSKCC)风险分类及骨转移相关。

Efficacy of sorafenib correlates with Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification and bone metastasis in Chinese patients with metastatic renal cell carcinoma.

作者信息

Zhang Yushi, Li Yongqiang, Cai Yi, Wang Ke, Li Hanzhong

机构信息

Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan Dongdan, Dongcheng District, Beijing, 100730, China.

Department of Epidemiology, Institute of Basic Medicine, Chinese Academy of Medical Sciences, Shuaifuyuan Dongdan, Dongcheng District, Beijing, 100730, China.

出版信息

Cell Oncol (Dordr). 2016 Feb;39(1):15-21. doi: 10.1007/s13402-015-0245-5. Epub 2015 Nov 23.

Abstract

PURPOSE

Several prognostic models have been developed to assess the efficacy and safety of sorafenib for metastatic renal cell carcinoma (mRCC), but few studies have validated its use in Chinese patients. The objective of this single center, single arm retrospective study was to examine the efficacy and safety of sorafenib and its related prognostic clinico-pathologic factors in Chinese mRCC patients.

METHODS

One hundred thirty four mRCC patients were enrolled. All patients received 400 mg of sorafenib orally twice daily. The dose was subsequently adjusted in the event of treatment-induced toxicity. Tumor response, progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were determined.

RESULTS

The median PFS and OS were 10 months (1-36 months) and 22 months (2-37 months), respectively. Complete, partial, and stable disease were observed in two (1.49%), 24 (17.91%), and 99 (73.88%) patients, respectively. Hand/foot skin reactions, diarrhea and fatigue were the most commonly observed AEs following sorafenib treatment. Among the AEs, only 13 grades 3 and 4 were observed. Multivariate analysis revealed that independent predictive factors for PFS included Eastern Cooperative Oncology Group (ECOG) status, Memorial Sloan-Kettering Cancer Center (MSKCC) risk status, and bone metastasis (all p < 0.05). Factors associated with OS included MSKCC risk values, bone metastasis and sorafenib-induced hypertension (all p < 0.05).

CONCLUSION

The introduction of sorafenib therapy for mRCC in Chinese patients may lead to a favorable disease control with acceptable tolerability. In addition, the parameters predicting favorable outcomes, including ECOG status, MSKCC risk status and bone metastasis, may have prognostic value in clinical practice.

摘要

目的

已经开发了几种预后模型来评估索拉非尼治疗转移性肾细胞癌(mRCC)的疗效和安全性,但很少有研究在中国患者中验证其应用。这项单中心、单臂回顾性研究的目的是探讨索拉非尼在中国mRCC患者中的疗效、安全性及其相关的预后临床病理因素。

方法

纳入134例mRCC患者。所有患者均接受索拉非尼口服,400mg,每日两次。随后在出现治疗诱导毒性的情况下调整剂量。确定肿瘤反应、无进展生存期(PFS)、总生存期(OS)和不良事件(AE)。

结果

中位PFS和OS分别为10个月(1 - 36个月)和22个月(2 - 37个月)。分别有2例(1.49%)、24例(17.91%)和99例(73.88%)患者观察到完全缓解、部分缓解和病情稳定。手足皮肤反应、腹泻和疲劳是索拉非尼治疗后最常观察到的AE。在这些AE中,仅观察到13例3级和4级AE。多因素分析显示,PFS的独立预测因素包括东部肿瘤协作组(ECOG)状态、纪念斯隆凯特琳癌症中心(MSKCC)风险状态和骨转移(所有p<0.05)。与OS相关的因素包括MSKCC风险值、骨转移和索拉非尼诱导的高血压(所有p<0.05)。

结论

在中国患者中引入索拉非尼治疗mRCC可能会带来良好的疾病控制且耐受性可接受。此外,预测良好结局的参数,包括ECOG状态、MSKCC风险状态和骨转移,可能在临床实践中具有预后价值。

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