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Lanreotide Autogel 在不可切除或转移性高分化神经内分泌肿瘤日本患者中的 II 期研究。

Phase II study of lanreotide autogel in Japanese patients with unresectable or metastatic well-differentiated neuroendocrine tumors.

机构信息

Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Maidashi 3-1-1, Fukuoka Higashi-ku, Fukuoka, Japan.

Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan.

出版信息

Invest New Drugs. 2017 Aug;35(4):499-508. doi: 10.1007/s10637-017-0466-8. Epub 2017 May 3.

Abstract

UNLABELLED

Background Lanreotide is a long-acting somatostatin analog with demonstrated efficacy against enteropancreatic neuroendocrine tumor (NET) in the phase III (CLARINET) study. Materials and Methods In this single-arm study, Japanese patients with grade (G) 1/G2 NET received lanreotide (120 mg/4 weeks) for 48 weeks. Those who completed the study were enrolled in a long-term extension study. The primary endpoint was the clinical benefit rate (CBR) defined as a complete response, partial response (PR), or stable disease (SD) over 24-weeks. Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), safety, and pharmacokinetics. Results Thirty-two patients were recruited at 10 sites. The full analysis set (FAS) comprised 28 patients. Primary tumors were located in pancreas (12 patients), foregut (non-pancreas, lung; 1), midgut (2), hindgut (8), and unknown (5). Four patients had gastrinoma of the functional NET, and 3 had multiple endocrine neoplasia type 1. In the FAS, 39.3% had progressive disease at baseline. The CBR at 24 weeks was 64.3% (95% confidence interval; CI: 44.1-81.4), and median PFS was 36.3 weeks (95% CI: 24.1-53.1). PR was confirmed in 1 patient at 60 weeks during the extension study (ORR: 3.6%). Frequent adverse events related to lanreotide included injection site induration (28.1%), faeces pale (18.8%), flatulence (12.5%), and diabetes mellitus (12.5%). Conclusions The efficacy and safety of lanreotide in this study indicated its usefulness as a treatment option for Japanese NET patients.

TRIAL REGISTRATION

JapicCTI-132,375, JapicCTI-142,698.

摘要

背景

兰瑞肽是一种长效生长抑素类似物,在 III 期 CLARINET 研究中已被证明对肠胰神经内分泌肿瘤(NET)有效。

材料和方法

在这项单臂研究中,日本 G1/G2 NET 患者接受兰瑞肽(120mg/4 周)治疗 48 周。完成研究的患者被纳入长期扩展研究。主要终点是临床获益率(CBR),定义为 24 周时完全缓解、部分缓解(PR)或疾病稳定(SD)。次要终点包括无进展生存期(PFS)、客观缓解率(ORR)、安全性和药代动力学。

结果

在 10 个地点招募了 32 名患者。全分析集(FAS)包括 28 名患者。原发肿瘤位于胰腺(12 例)、前肠(非胰腺、肺;1 例)、中肠(2 例)、后肠(8 例)和未知(5 例)。4 例患者患有胃泌素瘤功能性 NET,3 例患者患有多发性内分泌肿瘤 1 型。在 FAS 中,基线时有 39.3%的患者发生进展性疾病。24 周时 CBR 为 64.3%(95%置信区间;CI:44.1-81.4),中位 PFS 为 36.3 周(95%CI:24.1-53.1)。在扩展研究中,1 例患者在 60 周时确认 PR(ORR:3.6%)。与兰瑞肽相关的常见不良事件包括注射部位硬结(28.1%)、粪便苍白(18.8%)、气胀(12.5%)和糖尿病(12.5%)。

结论

该研究中兰瑞肽的疗效和安全性表明其可作为日本 NET 患者的治疗选择。

试验注册

JapicCTI-132,375,JapicCTI-142,698。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b769/5502055/c78de4cba901/10637_2017_466_Fig1_HTML.jpg

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