Schuetze Scott M, Bolejack Vanessa, Choy Edwin, Ganjoo Kristen N, Staddon Arthur P, Chow Warren A, Tawbi Hussein A, Samuels Brian L, Patel Shreyaskumar R, von Mehren Margaret, D'Amato Gina, Leu Kirsten M, Loeb David M, Forscher Charles A, Milhem Mohammed M, Rushing Daniel A, Lucas David R, Chugh Rashmi, Reinke Denise K, Baker Laurence H
University of Michigan, Ann Arbor, Michigan.
Cancer Research and Biostatistics, Seattle, Washington.
Cancer. 2017 Jan 1;123(1):90-97. doi: 10.1002/cncr.30379. Epub 2016 Oct 3.
Alveolar soft part sarcoma (ASPS), chondrosarcoma (CS), chordoma, epithelioid sarcoma, and solitary fibrous tumor (SFT) are malignant tumors that are relatively resistant to chemotherapy and for which more effective drug therapy is needed.
The 5 listed subtypes were enrolled into a single indolent sarcoma cohort in a phase 2 study of dasatinib using a Bayesian continuous monitoring rule for enrollment. The primary objective was to estimate the 6-month progression-free survival (PFS) rate according to the Choi criteria with a target of ≥50%. Cross-sectional imaging was performed before the start of treatment, every 2 months for 6 months, and then every 3 months during treatment. The 2- and 5-year survival rates were determined.
One hundred sixteen patients were enrolled within 45 months, and 109 began treatment with dasatinib. The 6-month PFS rate and the median PFS were 48% and 5.8 months, respectively. The PFS rate at 6 months was highest with ASPS (62%) and lowest with SFT (30%). More than 10% of the patients with ASPS, CS, or chordoma had stable disease for more than 1 year. Collectively, for all 5 subtypes, the 2- and 5-year overall survival rates were 44% and 13%, respectively. An objective response was observed in 18% of the patients with CS or chordoma.
Dasatinib failed to achieve control of sarcoma growth for at least 6 months in more than 50% of the patients in this trial according to the Choi tumor response criteria. An objective tumor response and prolonged stable disease was observed in >10% of patients with CS or chordoma. Cancer 2017;90-97. © 2016 American Cancer Society.
肺泡软组织肉瘤(ASPS)、软骨肉瘤(CS)、脊索瘤、上皮样肉瘤和孤立性纤维性肿瘤(SFT)是对化疗相对耐药的恶性肿瘤,需要更有效的药物治疗。
在一项达沙替尼的2期研究中,采用贝叶斯连续监测规则入组,将上述5种列出的亚型纳入一个单一的惰性肉瘤队列。主要目标是根据Choi标准估计6个月无进展生存率(PFS),目标是≥50%。在治疗开始前、治疗的前6个月每2个月以及治疗期间每3个月进行一次横断面成像。确定2年和5年生存率。
45个月内共入组116例患者,109例开始使用达沙替尼治疗。6个月PFS率和中位PFS分别为48%和5.8个月。ASPS患者6个月时的PFS率最高(62%),SFT患者最低(30%)。超过10%的ASPS、CS或脊索瘤患者疾病稳定超过1年。总体而言,对于所有5种亚型,2年和5年总生存率分别为44%和13%。18%的CS或脊索瘤患者观察到客观缓解。
根据Choi肿瘤反应标准,在该试验中超过50%的患者中,达沙替尼未能实现对肉瘤生长至少6个月的控制。在超过10%的CS或脊索瘤患者中观察到客观肿瘤反应和疾病长期稳定。《癌症》2017;90 - 97。©2016美国癌症协会。