Oya Mototsugu, Tomita Yoshihiko, Fukasawa Satoshi, Shinohara Nobuo, Habuchi Tomonori, Rini Brian I, Fujii Yosuke, Kamei Yoichi, Umeyama Yoshiko, Bair Angel H, Uemura Hirotsugu
Department of Urology, Keio University School of Medicine, Tokyo, Japan.
Department of Urology, Yamagata University Faculty of Medicine, Yamagata, Japan.
Cancer Sci. 2017 Jun;108(6):1231-1239. doi: 10.1111/cas.13232. Epub 2017 May 22.
Subgroup analyses of a randomized global phase II study of axitinib showed objective response rate of 66% and median progression-free survival of 27.6 months in treatment-naïve Japanese patients with metastatic renal cell carcinoma (RCC). This analysis evaluated overall survival (OS) and safety in 44 Japanese patients and compared the results with 169 non-Japanese patients. In addition, baseline characteristics for predictive factors that may influence OS in first-line metastatic RCC were explored in all patients using a Cox proportional hazard model. With median follow-up of 33 months, fewer than half (16 of 44) of the Japanese patients had died and median OS was not reached (95% confidence interval [CI], 38.8 months-not estimable), whereas 107 of 169 (63%) non-Japanese patients had died and median OS was 33.9 months (95% CI, 28.9-42.7). Estimated 1-year, 2-year and 3-year survival probability (95% CI) was 86.4% (76.2-96.5), 75.0% (62.2-87.8) and 68.2% (54.4-81.9), respectively, in Japanese patients, and was higher than that in non-Japanese patients (75.1% [68.4-81.8], 62.1% [54.5-69.7] and 47.2% [39.3-55.1], respectively). The updated safety analysis did not reveal any new adverse events of concern among Japanese or non-Japanese patients. The multivariate analysis identified that lower baseline Eastern Cooperative Oncology Group performance status, lower baseline tumor burden, and longer time from histopathological diagnosis to treatment were significant positive predictors of OS. The current analysis confirmed the clinical activity of axitinib in treatment-naïve Japanese patients with metastatic RCC, with an acceptable toxicity profile.
一项关于阿昔替尼的随机全球II期研究的亚组分析显示,在未经治疗的日本转移性肾细胞癌(RCC)患者中,客观缓解率为66%,无进展生存期的中位数为27.6个月。该分析评估了44例日本患者的总生存期(OS)和安全性,并将结果与169例非日本患者进行了比较。此外,使用Cox比例风险模型在所有患者中探索了可能影响一线转移性RCC患者OS的预测因素的基线特征。中位随访33个月时,不到一半(44例中的16例)的日本患者死亡,OS中位数未达到(95%置信区间[CI],38.8个月-不可估计),而169例非日本患者中有107例(63%)死亡,OS中位数为33.9个月(95%CI,28.9-42.7)。日本患者估计的1年、2年和3年生存概率(95%CI)分别为86.4%(76.2-96.5)、75.0%(62.2-87.8)和68.2%(54.4-81.9),高于非日本患者(分别为75.1%[68.4-81.8]、62.1%[54.5-69.7]和47.2%[39.3-55.1])。更新后的安全性分析未发现日本或非日本患者中有任何新的不良事件值得关注。多变量分析确定,较低的基线东部肿瘤协作组体能状态、较低的基线肿瘤负荷以及从组织病理学诊断到治疗的时间较长是OS的显著阳性预测因素。当前分析证实了阿昔替尼在未经治疗的日本转移性RCC患者中的临床活性,且毒性特征可接受。