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纳米白蛋白结合型紫杉醇方案用于复发性小细胞肺癌的疗效:一项回顾性分析。

Efficacy of nanoparticle albumin-bound paclitaxel regimens for relapsed small cell lung cancer: A retrospective analysis.

作者信息

Naito Yujiro, Tamiya Akihiro, Tamiya Motohiro, Kimura Yohei, Hamaguchi Masanari, Saijo Nobuhiko, Kanazu Masaki, Tokura Sayoko, Shiroyama Takayuki, Morisita Naoko, Omachi Naoki, Suzuki Hidekazu, Okamoto Norio, Okishio Kyoichi, Hirashima Tomonori, Atagi Shinji

机构信息

Department of Internal Medicine, National Hospital Organization Kinki-chuo Chest Medical Center Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita City Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Habikino City Department of Respiratory Internal Medicine, Osaka International Cancer Institute Department of Thoracic Oncology, National Hospital Organization Toneyama National Hospital, Toyonaka City Department of Thoracic Oncology, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai City, Osaka, Japan.

出版信息

Medicine (Baltimore). 2017 Sep;96(35):e7884. doi: 10.1097/MD.0000000000007884.

Abstract

Although small cell lung cancer (SCLC) is initially sensitive to chemotherapy, it recurs in most cases. Standard regimens for salvage chemotherapy have not been established, and the prognosis of relapsed SCLC remains poor. In the present study, we investigated the clinical efficacy and safety of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) regimens for the treatment of relapsed SCLC.In this retrospective multicenter analysis, 14 patients (3 women and 11 men; median age 71 years) with relapsed SCLC received nab-paclitaxel alone or in combination with carboplatin between February 2013 and July 2014. The safety and efficacy of the regimens were evaluated.The response rates, disease control rates, and median overall survival for the total patient population were 36%, 64%, and 7.8 months, respectively. Response rates, disease control rates, and the median overall survival were 11%, 44%, and 4 months, respectively, in the monotherapy group; and 80%, 100%, and 10.6 months, respectively, in the combination therapy group. The most common adverse events were hematological toxicities such as neutropenia and anemia. Severe neutropenia appeared in some patients, although it was resolved by treatment in all. The most common nonhematological toxicity was anorexia (64%), followed by neurotoxicity and constipation. All nonhematological toxicities were mild and manageable.Our results suggest that chemotherapy with nab-paclitaxel regimens for relapsed SCLC exhibits moderate clinical efficacy and is well-tolerated. Further clinical trials in relapsed SCLC patients are warranted.

摘要

尽管小细胞肺癌(SCLC)最初对化疗敏感,但大多数情况下会复发。挽救性化疗的标准方案尚未确立,复发SCLC的预后仍然很差。在本研究中,我们调查了纳米白蛋白结合型紫杉醇(白蛋白结合型紫杉醇)方案治疗复发SCLC的临床疗效和安全性。在这项回顾性多中心分析中,14例复发SCLC患者(3例女性和11例男性;中位年龄71岁)在2013年2月至2014年7月期间接受了单独的白蛋白结合型紫杉醇或与卡铂联合治疗。评估了这些方案的安全性和疗效。总患者人群的缓解率、疾病控制率和中位总生存期分别为36%、64%和7.8个月。单药治疗组的缓解率、疾病控制率和中位总生存期分别为11%、44%和4个月;联合治疗组分别为80%、100%和10.6个月。最常见的不良事件是血液学毒性,如中性粒细胞减少和贫血。一些患者出现了严重的中性粒细胞减少,尽管通过治疗所有患者均得到缓解。最常见的非血液学毒性是厌食(64%),其次是神经毒性和便秘。所有非血液学毒性均为轻度且可控。我们的结果表明,白蛋白结合型紫杉醇方案化疗对复发SCLC具有中等临床疗效且耐受性良好。有必要对复发SCLC患者进行进一步的临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77ef/5585497/0dbbe9c4bdfc/medi-96-e7884-g004.jpg

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