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一项关于无聚氧乙烯蓖麻油的紫杉醇聚合物胶束制剂联合卡铂作为晚期卵巢癌一线治疗的开放标签、多中心、I期试验:韩国妇科肿瘤学组研究(KGOG-3016)

An open-label, multicenter, phase I trial of a cremophor-free, polymeric micelle formulation of paclitaxel combined with carboplatin as a first-line treatment for advanced ovarian cancer: a Korean Gynecologic Oncology Group study (KGOG-3016).

作者信息

Lee Shin Wha, Kim Yong Man, Kim Young Tae, Kang Soon Beom

机构信息

Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, Seoul, Korea.

出版信息

J Gynecol Oncol. 2017 May;28(3):e26. doi: 10.3802/jgo.2017.28.e26. Epub 2016 Dec 19.

Abstract

OBJECTIVE

This phase I study aimed to determine the maximum tolerated dose (MTD) of Genexol-PM, when combined with carboplatin, as a first-line treatment in patients with advanced ovarian cancer.

METHODS

This open-label, multicenter, phase I, dose-escalation study included 18 patients (median age: 59.0 years, range: 40-75 years) diagnosed with advanced epithelial ovarian cancer. All patients had measurable residual disease after debulking surgery. Patients were assigned to groups (n=6 each group) that received different doses of Genexol-PM (220, 260, and 300 mg/m², once every 3 weeks) and 5 area under the curve (AUC) carboplatin. Safety and efficacy were analyzed for each dose group.

RESULTS

In this intention-to-treat population, 3 out of 18 patients dropped out of the study: 1 due to dose-limiting toxicity (DLT), 1 due to hypersensitivity, and 1 was lost during follow-up. DLTs were not reported at 220 mg/m² or 260 mg/m², but at 300 mg/m², 1 patient experienced DLT (grade 3 general pain). The MTD of Genexol-PM was not determined, but a dose of 300 mg/m² or less could be recommended for the phase II study. Most patients (73.9%) with adverse events recovered without sequelae, and no death occurred that was related to the disease or treatment. The best overall response rate was 94.1%.

CONCLUSION

Genexol-PM combined with carboplatin was well tolerated as a first-line treatment, and good responses were observed in patients with advanced ovarian cancer. Based on these results, we recommended a dose of 300 mg/m² or less for a phase II study.

摘要

目的

本I期研究旨在确定在晚期卵巢癌患者中,健择联合卡铂作为一线治疗时的最大耐受剂量(MTD)。

方法

本开放标签、多中心、I期剂量递增研究纳入了18例确诊为晚期上皮性卵巢癌的患者(中位年龄:59.0岁,范围:40 - 75岁)。所有患者在肿瘤细胞减灭术后均有可测量的残留病灶。患者被分为几组(每组n = 6),分别接受不同剂量的健择(220、260和300 mg/m²,每3周一次)和5个曲线下面积(AUC)的卡铂。对每个剂量组的安全性和疗效进行分析。

结果

在意向性治疗人群中,18例患者中有3例退出研究:1例因剂量限制性毒性(DLT),1例因超敏反应,1例在随访期间失访。在220 mg/m²或260 mg/m²剂量时未报告DLT,但在300 mg/m²剂量时,1例患者出现DLT(3级全身疼痛)。未确定健择的MTD,但可推荐300 mg/m²或更低剂量用于II期研究。大多数发生不良事件的患者(73.9%)康复且无后遗症,未发生与疾病或治疗相关的死亡。最佳总体缓解率为94.1%。

结论

健择联合卡铂作为一线治疗耐受性良好,晚期卵巢癌患者观察到良好反应。基于这些结果,我们推荐300 mg/m²或更低剂量用于II期研究。

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