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索拉非尼单药治疗晚期肝内胆管癌的单中心经验。

A single-center experience of sorafenib monotherapy in patients with advanced intrahepatic cholangiocarcinoma.

作者信息

Pan Ting-Ting, Wang Wei, Jia Wei-Dong, Xu Ge-Liang

机构信息

Department of Hepatic Surgery, Affiliated Provincial Hospital of Anhui Medical University, Hefei, Anhui 230001, P.R. China.

Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, Anhui 230001, P.R. China.

出版信息

Oncol Lett. 2017 May;13(5):2957-2964. doi: 10.3892/ol.2017.5847. Epub 2017 Mar 13.

Abstract

Patients with advanced intrahepatic cholangiocarcinoma (ICC) have a poor prognosis and the therapeutic options available for treating ICC are limited. Sorafenib, a multikinase inhibitor of vascular endothelial growth factor receptor 2 and 3, platelet derived growth factor receptor-β, B-Raf proto-oncogene, serine/threonine kinase and C-Raf proto-oncogene, serine/threonine kinase, is a novel reference standard for the treatment of advanced hepatocellular carcinoma. Sorafenib has previously been demonstrated to exhibit significant antitumor activity in various cholangiocarcinoma cell lines and in xenograft ICC models. The present study aimed to assess the efficacy and safety of sorafenib as a single-agent treatment in patients with advanced ICC. Eligible patients were administere no prior therapy for metastatic or unresectable disease. Sorafenib was administered orally at a dose of 400 mg twice daily continuously. The primary endpoint was considered as the disease control rate (DCR) at 12 weeks. Secondary endpoints included time to progression (TTP), progression-free survival (PFS), overall survival (OS), duration of treatment (DOT) and the adverse event profile. A total of 15 patients were enrolled in the present study, with a median DOT of 3.2 months (range, 1.5-30 months). A total of 4 patients achieved a partial response and 7 patients achieved stable disease, with a DCR of 73.3%. The median OS time was 5.7 months [95% confidence interval (CI), 5.0-6.4], the PFS time was 5.5 months (95% CI, 3.9-7.1) and the median TTP was 3.2 months (range, 1.5-29 months). The most common toxicity was a skin rash, which w1as observed in 5 patients (33.3%). Grade 3 hand-foot syndrome was observed in 1 patient (6.7%), which required treatment termination. The results of the present study suggest that sorafenib monotherapy may exhibit promising anticancer activity in patients with advanced ICC and that it has a manageable toxicity profile.

摘要

晚期肝内胆管癌(ICC)患者预后较差,且目前可用于治疗ICC的方法有限。索拉非尼是一种多激酶抑制剂,可抑制血管内皮生长因子受体2和3、血小板衍生生长因子受体-β、B-Raf原癌基因、丝氨酸/苏氨酸激酶以及C-Raf原癌基因、丝氨酸/苏氨酸激酶,是治疗晚期肝细胞癌的一种新型参考标准。此前已证明索拉非尼在多种胆管癌细胞系和异种移植ICC模型中具有显著的抗肿瘤活性。本研究旨在评估索拉非尼单药治疗晚期ICC患者的疗效和安全性。符合条件的患者此前未接受过针对转移性或不可切除疾病的治疗。索拉非尼以每日两次、每次400mg的剂量持续口服给药。主要终点为12周时的疾病控制率(DCR)。次要终点包括疾病进展时间(TTP)、无进展生存期(PFS)、总生存期(OS)、治疗持续时间(DOT)以及不良事件情况。本研究共纳入15例患者,中位DOT为3.2个月(范围:1.5 - 30个月)。共有4例患者达到部分缓解,7例患者病情稳定,DCR为73.3%。中位OS时间为5.7个月[95%置信区间(CI),5.0 - 6.4],PFS时间为5.5个月(95%CI,3.9 - 7.1),中位TTP为3.2个月(范围:1.5 - 29个月)。最常见的毒性反应为皮疹,5例患者(33.3%)出现该症状。1例患者(6.7%)出现3级手足综合征,需要终止治疗。本研究结果表明,索拉非尼单药治疗晚期ICC患者可能具有良好的抗癌活性,且毒性可控。

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