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尼妥珠单抗联合多西他赛治疗晚期非小细胞肺癌化疗难治/耐药患者的I期研究

A phase I study of nimotuzumab plus docetaxel in chemotherapy-refractory/resistant patients with advanced non-small-cell lung cancer.

作者信息

Zhao Jun, Zhuo Minglei, Wang Zhijie, Duan Jianchun, Wang Yuyan, Wang Shuhang, An Tongtong, Wu Meina, Wang Jie

机构信息

Departments of Thoracic Medical Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China.

出版信息

Chin J Cancer Res. 2016 Feb;28(1):12-8. doi: 10.3978/j.issn.1000-9604.2016.02.07.

Abstract

BACKGROUND

To determine the safety and therapeutic efficacy of nimotuzumab (h-R3) combined with docetaxel in advanced non-small-cell lung cancer (NSCLC) patients who have failed to respond to prior first-line chemotherapy.

METHODS

In this single-center, open-label, dose-escalating phase I trial, patients with epidermal growth factor receptor (EGFR)-expressing stage IV NSCLC were treated with nimotuzumab plus docetaxel according to a dose escalation schedule. The safety and efficacy of the combination treatment were observed and analyzed.

RESULTS

There were 12 patients with EGFR-expressing stage IV NSCLC enrolled. The dose of nimotuzumab was escalated from 200 to 600 mg/week. The longest administration of study drug was 40 weeks at the 600 mg/week dose level. Grade III-IV toxicities included neutropenia and fatigue, and other toxicities included rash. Dose-limiting toxicity occurred with Grade 3 fatigue at the 200 mg dose level of nimotuzumab and Grade 4 neutropenia with pneumonia at the 600 mg dose level of nimotuzumab. No objective responses were observed, and stable disease was observed in eight patients (66.7%). The median progression-free survival (PFS) was 4.4 months in all patients, 1.3 months in patients with the EGFR mutation, and 4.4 months in those with wild type EGFR (EGFR WT). The median survival time (MST) was 21.1 months in all patients, 21.1 months in patients with EGFR mutation, and 26.4 months in patients with EGFR WT.

CONCLUSIONS

Nimotuzumab and docetaxel combination therapy was found to be well tolerated and efficacious. Further study of nimotuzumab is warranted in advanced NSCLC patients.

摘要

背景

确定尼妥珠单抗(h-R3)联合多西他赛对一线化疗无效的晚期非小细胞肺癌(NSCLC)患者的安全性和治疗效果。

方法

在这项单中心、开放标签、剂量递增的I期试验中,根据剂量递增方案,对表皮生长因子受体(EGFR)表达的IV期NSCLC患者使用尼妥珠单抗加用多西他赛进行治疗。观察并分析联合治疗的安全性和疗效。

结果

共纳入12例EGFR表达的IV期NSCLC患者。尼妥珠单抗剂量从200mg/周递增至600mg/周。在600mg/周剂量水平下,研究药物最长给药时间为40周。III-IV级毒性包括中性粒细胞减少和疲劳,其他毒性包括皮疹。在尼妥珠单抗200mg剂量水平出现3级疲劳,在尼妥珠单抗600mg剂量水平出现4级中性粒细胞减少合并肺炎,均为剂量限制性毒性。未观察到客观缓解,8例患者(66.7%)病情稳定。所有患者的中位无进展生存期(PFS)为4.4个月,EGFR突变患者为1.3个月,野生型EGFR(EGFR WT)患者为4.4个月。所有患者的中位生存时间(MST)为21.1个月,EGFR突变患者为21.1个月,EGFR WT患者为26.4个月。

结论

尼妥珠单抗和多西他赛联合治疗耐受性良好且有效。晚期NSCLC患者有必要进一步研究尼妥珠单抗。

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