循环血管内皮生长因子（VEGF）作为晚期脊索瘤患者接受索拉非尼治疗时无进展生存期的预测因素：来自法国肉瘤组（GSF/GETO）II期试验的分析
Circulating vascular endothelial growth factor (VEGF) as predictive factor of progression-free survival in patients with advanced chordoma receiving sorafenib: an analysis from a phase II trial of the french sarcoma group (GSF/GETO).
作者信息
Lebellec Loic, Bertucci François, Tresch-Bruneel Emmanuelle, Bompas Emmanuelle, Toiron Yves, Camoin Luc, Mir Olivier, Laurence Valerie, Clisant Stephanie, Decoupigny Emilie, Blay Jean-Yves, Goncalves Anthony, Penel Nicolas
机构信息
Department of Medical Oncology, Centre Oscar Lambret, Lille, France.
Department of Medical Oncology, Institut Paoli-Calmette, Marseille, France.
出版信息
Oncotarget. 2016 Nov 8;7(45):73984-73994. doi: 10.18632/oncotarget.12172.
BACKGROUND
Patients with advanced chordoma are often treated with tyrosine kinase inhibitors without any predictive factor to guide decision. We report herein an ancillary analysis of the the Angionext phase II trial (NCT 00874874).
RESULTS
From May 2011 to January 2014, 26 were sampled. The 9-month PFS rate was 72.9% (95%-CI: 45.9-87.9). During sorafenib treatment, a significant increase in PlGF (18.4 vs 43.8 pg/mL, p<0.001) was noted along with a non-significant increase in VEGF (0.7 vs 1.0 ng/mL, p=0.07). VEGF at D1 >1.04 ng/mL (HR=12.5, 95%-CI: 1.37-114, p=0.025) and VEGF at D7 >1.36 ng/mL (HR=10.7, 95%-CI: 1.16-98, p=0.037) were associated with shorter PFS. The 9-month PFS rate was 92.3% (95%-CI: 56.6-98.9) when VEGF at D1 was ≤1.04 ng/mL versus 23.3% (95%-CI: 1.0-63.2) when >1.04 ng/mL.
PATIENTS AND METHODS
Chordoma patients were treated with sorafenib 800 mg/day for 9 months, unless earlier occurrence of progression or toxicities. Six biomarkers (sE-Selectin, VEGF, VEGF-C, placental growth factor (PlGF), Thrombospondin, Stem Cell Factor (SCF)) were measured at baseline (day 1: D1) and day 7 (D7).
CONCLUSION
High levels of VEGF was associated with poor outcome.
背景
晚期脊索瘤患者常接受酪氨酸激酶抑制剂治疗，却没有任何预测因素来指导决策。我们在此报告Angionext II期试验（NCT 00874874）的一项辅助分析。
结果
2011年5月至2014年1月，共抽取了26例样本。9个月的无进展生存率为72.9%（95%置信区间：45.9 - 87.9）。在索拉非尼治疗期间，发现胎盘生长因子（PlGF）显著升高（18.4对43.8 pg/mL，p<0.001），而血管内皮生长因子（VEGF）虽有升高但不显著（0.7对1.0 ng/mL，p = 0.07）。第1天（D1）时VEGF>1.04 ng/mL（风险比[HR]=12.5，95%置信区间：1.37 - 114，p = 0.025）以及第7天（D7）时VEGF>1.36 ng/mL（HR = 10.7，95%置信区间：1.16 - 98，p = 0.037）与较短的无进展生存期相关。当第1天VEGF≤1.04 ng/mL时，9个月的无进展生存率为92.3%（95%置信区间：56.6 - 98.9）；而当VEGF>1.04 ng/mL时，无进展生存率为23.3%（95%置信区间：1.0 - 63.2）。
患者与方法
脊索瘤患者接受索拉非尼800 mg/天治疗9个月，除非更早出现疾病进展或毒性反应。在基线（第1天：D1）和第7天（D7）测量六种生物标志物（可溶性E选择素、VEGF、VEGF - C、胎盘生长因子（PlGF）、血小板反应蛋白、干细胞因子（SCF））。
结论
高水平的VEGF与不良预后相关。
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