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依维莫司单药治疗难治性或复发性霍奇金淋巴瘤:巴西指定患者项目经验

Everolimus as a single agent in refractory or relapsed Hodgkin's lymphoma: the Brazilian Named Patient Program Experience.

作者信息

Rocha Talita Máira Bueno da Silveira da, Fortier Sergio Costa, Fischer Thais Rodrigues da Cunha, Perini Guilherme Fleury, Gaiolla Rafael Dezen, Fogliatto Laura, Delamain Marcia Torresan, Costa Andressa Fragoso da, Castro Nelson Siqueira de, Barretos Wolney Gois, Souza Cármino Antonio de, Buccheri Valéria, Chiattone Carlos Sérgio

机构信息

Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.

Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.

出版信息

Rev Bras Hematol Hemoter. 2017 Jul-Sep;39(3):216-222. doi: 10.1016/j.bjhh.2017.03.008. Epub 2017 May 11.

Abstract

BACKGROUND

Despite all the scientific progress that has been made on understanding the disease, prognosis for patients with relapsed and refractory Hodgkin's lymphoma remains poor and the treatment is palliative in the majority of the cases. Thus, the aim of this study was to present the results on the compassionate use of everolimus in a group of patients who were monitored at nine different centers in Brazil.

METHODS

A 10-mg oral dose of everolimus was given to each patient daily. Response time was evaluated from the beginning of medication use until loss of response, toxicity or medical decision to cease treatment.

RESULTS

Thirty-three patients were evaluated. The median age at the beginning of medication administration was 29 years. Patients had received a median of five prior therapies. Overall response rate was 45.4%, with 13 patients achieving partial response, two achieved clinical response, 14 remained with stable disease, two had disease progression, and two were not evaluated. Patients received a median of 14 cycles. Progression-free survival was nine months, and overall survival was estimated to be 36 months. Three patients used the medication for more than four years. The most frequently reported adverse events were thrombocytopenia and hypercholesterolemia. Three patients had pulmonary toxicity. Grade III and IV adverse events occurred in 39% of the patients.

CONCLUSION

Everolimus was found to provide a response in a group of patients with refractory or relapsed Hodgkin's lymphoma who had adequate tolerability to the drug.

摘要

背景

尽管在理解该疾病方面已取得了所有科学进展,但复发和难治性霍奇金淋巴瘤患者的预后仍然很差,并且在大多数情况下治疗是姑息性的。因此,本研究的目的是呈现依维莫司在巴西九个不同中心监测的一组患者中同情用药的结果。

方法

每天给每位患者口服10毫克依维莫司。从开始用药直至失去反应、出现毒性或医生决定停止治疗来评估反应时间。

结果

评估了33例患者。开始用药时的中位年龄为29岁。患者此前接受的治疗中位数为5次。总体缓解率为45.4%,13例患者达到部分缓解,2例达到临床缓解,14例病情稳定,2例疾病进展,2例未评估。患者接受的治疗周期中位数为14个。无进展生存期为9个月,总生存期估计为36个月。3例患者用药超过4年。最常报告的不良事件是血小板减少症和高胆固醇血症。3例患者出现肺部毒性。39%的患者发生了III级和IV级不良事件。

结论

发现依维莫司在一组对该药物具有足够耐受性的难治性或复发性霍奇金淋巴瘤患者中产生了反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2784/5567422/a80e46a2bda0/gr1.jpg

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