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阿昔替尼一线治疗转移性肾细胞癌随机II期研究中剂量滴定与否的总生存分析

Overall Survival Analysis From a Randomized Phase II Study of Axitinib With or Without Dose Titration in First-Line Metastatic Renal Cell Carcinoma.

作者信息

Rini Brian I, Tomita Yoshihiko, Melichar Bohuslav, Ueda Takeshi, Grünwald Viktor, Fishman Mayer N, Uemura Hirotsugu, Oya Mototsugu, Bair Angel H, Andrews Glen I, Rosbrook Brad, Jonasch Eric

机构信息

Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.

Department of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

Clin Genitourin Cancer. 2016 Dec;14(6):499-503. doi: 10.1016/j.clgc.2016.04.005. Epub 2016 Apr 22.

Abstract

BACKGROUND

In a randomized phase II trial in metastatic renal cell carcinoma (mRCC), objective response rate was significantly higher with axitinib versus placebo titration (54% vs. 34%; 1-sided P = .019).

PATIENTS AND METHODS

Treatment-naive patients with mRCC (n = 213) received axitinib 5 mg twice per day (b.i.d.) for 4 weeks. Patients meeting dose titration criteria were randomized to receive axitinib 5 mg b.i.d. with axitinib or placebo titration (n = 56 each); 91 patients ineligible for randomization continued axitinib 5 mg b.i.d.; 10 discontinued before randomization.

RESULTS

Median overall survival (95% confidence interval [CI]) was 42.7 months (24.7-not estimable) with axitinib titration versus 30.4 months (23.7-45.0) with placebo titration (stratified hazard ratio, 0.785; 95% CI, 0.485-1.272; 1-sided P = .162), and 41.6 months (95% CI, 33.0-not estimable) in nonrandomized patients. Safety data were consistent with previous reports.

CONCLUSION

Median overall survival was numerically longer in patients with first-line mRCC who received axitinib versus placebo titration. No new safety signal was observed after long-term axitinib treatment in first-line mRCC.

摘要

背景

在一项转移性肾细胞癌(mRCC)的随机II期试验中,阿昔替尼滴定组的客观缓解率显著高于安慰剂滴定组(54% 对34%;单侧P = 0.019)。

患者和方法

初治的mRCC患者(n = 213)接受阿昔替尼5 mg每日两次(b.i.d.)治疗4周。符合剂量滴定标准的患者被随机分配接受阿昔替尼5 mg b.i.d.联合阿昔替尼或安慰剂滴定(各n = 56);91例不符合随机化条件的患者继续接受阿昔替尼5 mg b.i.d.治疗;10例在随机化前停药。

结果

阿昔替尼滴定组的中位总生存期(95%置信区间[CI])为42.7个月(24.7 - 不可估计),安慰剂滴定组为30.4个月(23.7 - 45.0)(分层风险比,0.785;95% CI,0.485 - 1.272;单侧P = 0.162),非随机化患者为41.6个月(95% CI,33.0 - 不可估计)。安全性数据与既往报告一致。

结论

一线mRCC患者接受阿昔替尼滴定的中位总生存期在数值上长于接受安慰剂滴定的患者。一线mRCC长期接受阿昔替尼治疗后未观察到新的安全信号。

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