Song Y, Du C X, Zhang W, Sun Y K, Yang L, Cui C X, Yihebali Chi, Zhou A P, Wang J W, Sun Y
Department of Medical Oncology, Cancer Hospital and Institute, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100021, China.
Zhonghua Yi Xue Za Zhi. 2016 Sep 13;96(34):2717-2721. doi: 10.3760/cma.j.issn.0376-2491.2016.34.006.
To investigate the association between hand-foot skin reaction (HFSR) in the treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) and the effectiveness of VEGFR-TKIs. Clinical data of 155 patients with metastatic renal cell carcinoma (mRCC) treated with VEGFR-TKIs at the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and January 2014 were retrospectively analyzed. All the patients received first-line VEGFR-TKI therapy. The treatment effectiveness and outcome between patients developing HFSR and those without HFSR were compared. Comparison of treatment response rate (RR) was performed with χ test, survival analysis was performed using Kaplan-Meier method, with a significance level of 0.05. The median survival of all the 155 patients was 36.2 months. Among the 117 (75.5%) patients who developed HFSR, 19 patients (12.3%) had grade Ⅰ HFSR, 73 (47.1%) had grade Ⅱ, and 25 (16.1%) had grade Ⅲ; there were no grade Ⅳ events. The RR and median progression-free survival (mPFS) in patients who did not develop HFSR were 15.8% and 6.7 months, respectively; while the RR and mPFS in patients who developed HFSR were 52.1% and 13.8 months, respectively (<0.001, =0.002). The RR and mPFS in patients with grade Ⅰ HFSR were 42.1% and 9.5 months, respectively; those in patients with grade Ⅱ HFSR were 56.2% and 12.2 months, respectively, in patients with grade Ⅲ were 48.0% and 22.2 months, respectively, with statistically significant differences among the three grades of HFSR (=0.001, 0.009). HFSR might be an effective predictor for effectiveness of VEGFR-TKIs in mRCC patients. Large-sample studies are warranted to further prove these results.
探讨血管内皮生长因子受体酪氨酸激酶抑制剂(VEGFR-TKIs)治疗过程中手足皮肤反应(HFSR)与VEGFR-TKIs疗效之间的关联。回顾性分析了2006年1月至2014年1月在中国医学科学院肿瘤医院接受VEGFR-TKIs治疗的155例转移性肾细胞癌(mRCC)患者的临床资料。所有患者均接受一线VEGFR-TKI治疗。比较了发生HFSR的患者与未发生HFSR的患者的治疗效果和预后。采用χ检验比较治疗缓解率(RR),采用Kaplan-Meier法进行生存分析,显著性水平为0.05。155例患者的中位生存期为36.2个月。在发生HFSR的117例(75.5%)患者中,19例(12.3%)为Ⅰ级HFSR,73例(47.1%)为Ⅱ级,25例(16.1%)为Ⅲ级;无Ⅳ级事件。未发生HFSR的患者的RR和中位无进展生存期(mPFS)分别为15.8%和6.7个月;而发生HFSR的患者的RR和mPFS分别为52.1%和13.8个月(<0.001,=0.002)。Ⅰ级HFSR患者的RR和mPFS分别为42.1%和9.5个月;Ⅱ级HFSR患者分别为56.2%和12.2个月,Ⅲ级患者分别为48.0%和22.2个月,HFSR的三个等级之间差异有统计学意义(=0.001,0.009)。HFSR可能是mRCC患者VEGFR-TKIs疗效的有效预测指标。需要大样本研究进一步证实这些结果。