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SPI-1620与多西他赛联合作为二线晚期胆管癌治疗的2期研究。

Phase 2 study of combination SPI-1620 with docetaxel as second-line advanced biliary tract cancer treatment.

作者信息

Kim Richard, Chiorean E Gabriela, Amin Manik, Rocha-Lima Caio Max S, Gandhi Jitendra, Harris William P, Song Tao, Portnoy David

机构信息

Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center &Research Institute, 12902 Magnolia Drive FOB-2, Tampa, FL 33612, USA.

Division of Oncology, Department of Medicine, University of Washington, 825 Eastlake Avenue E, G4-833, Seattle, WA 98109-1023, USA.

出版信息

Br J Cancer. 2017 Jul 11;117(2):189-194. doi: 10.1038/bjc.2017.160. Epub 2017 Jun 20.

Abstract

BACKGROUND

This multicentre, open-label study evaluated the efficacy and safety of SPI-1620, an analogue of endothelin-1, administered in combination with docetaxel as second-line treatment for patients with advanced biliary tract cancer (ABTC).

METHODS

Eligible patients received continuous cycles of combination therapy with SPI-1620 (11 μg m) and docetaxel (75 mg m) intravenously every 3 weeks until disease progression (PD) or intolerable toxicity. Tumour response was evaluated using computed tomography or magnetic resonance imaging every 2 cycles (6 weeks). The primary efficacy end point was progression-free survival (PFS); secondary end points included overall response rate (ORR), duration of response, and overall survival (OS) that were estimated using the Kaplan-Meier method.

RESULTS

Of the 30 enrolled patients, 25 patients had qualifying events (PD or death), 1 patient was nonevaluable, and 4 patients were censored at the time of their last tumour assessment. Our primary end point of PFS ⩾5 months was not reached. Median PFS was 2.6 months (95% confidence interval (CI): 1.4-2.8), ranging from 0.7 to 8.4 months. The ORR was 10.3% (95% CI: 0.02-0.27). Eleven additional patients achieved stable disease. The OS was 4.87 months. The most common grade 3-4 toxicities were febrile neutropenia and neutropenia.

CONCLUSIONS

The addition of docetaxel to SPI-1620 in second-line ABTC did not meet the pre-specified primary end point of PFS ⩾5 months in unselected patient population.

摘要

背景

本多中心、开放标签研究评估了内皮素-1类似物SPI-1620联合多西他赛作为晚期胆管癌(ABTC)患者二线治疗的疗效和安全性。

方法

符合条件的患者每3周接受一次SPI-1620(11μg/m)和多西他赛(75mg/m)静脉联合治疗,持续多个周期,直至疾病进展(PD)或出现不可耐受的毒性。每2个周期(6周)使用计算机断层扫描或磁共振成像评估肿瘤反应。主要疗效终点为无进展生存期(PFS);次要终点包括总缓解率(ORR)、缓解持续时间和总生存期(OS),采用Kaplan-Meier方法进行估计。

结果

30例入组患者中,25例发生符合条件的事件(PD或死亡),1例无法评估,4例在最后一次肿瘤评估时被 censored。我们设定的PFS≥5个月的主要终点未达到。中位PFS为2.6个月(95%置信区间(CI):1.4 - 2.8),范围为0.7至8.4个月。ORR为10.3%(95%CI:0.02 - 0.27)。另外11例患者病情稳定。OS为4.87个月。最常见的3 - 4级毒性反应为发热性中性粒细胞减少和中性粒细胞减少。

结论

在未选择的患者群体中,二线ABTC患者在SPI-1620基础上加用多西他赛未达到预先设定的PFS≥5个月的主要终点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06d/5520510/bf327dace474/bjc2017160f1.jpg

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