Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Saitama, 359-8513, Japan.
Department of Clinical Oncology, National Defense Medical College Hospital, Tokorozawa, Saitama, 359-8513, Japan.
Cancer Chemother Pharmacol. 2018 Jan;81(1):111-117. doi: 10.1007/s00280-017-3454-y. Epub 2017 Nov 9.
We aimed to retrospectively evaluate the efficacy and toxicity of an irinotecan hydrochloride (CPT) and nedaplatin (N) combination therapy for recurrent and refractory endometrial carcinoma, administered based on UGT1A1 genotype.
Between 2009 and 2017, 21 patients who received CPT-N therapy for recurrent endometrial carcinoma as second- or third-line chemotherapy at our hospital were identified. The CPT-N regimen included 40-70 mg/m of CPT-11 on days 1, 8, and 15, and 50 mg/m of nedaplatin on day 1, q4 weeks.
The median patient age was 63 years. The number of prior chemotherapeutic regimens ranged from 1 to 2. Two patients had prior pelvic irradiation. The response rate [ratio of complete remission (CR) to partial remission (PR)] of CPT-N therapy was 3 of 21 (14.3%), and clinical benefit rate (CBR) [the combined percentages of CR, PR, and stable disease (SD)] was 9 of 21 (42.8%). Toxicities included grade 3 neutropenia [4 (19.0%) cases], grade 3 febrile neutropenia [2 (9.5%) cases], and grade 3 diarrhea [3 (14.3%) cases]; all resolved with conservative treatment. Patients with a wild-type UGT1A1 status received higher doses of CPT-11 (p = 0.048) and had similar RR and CBR compared to those with a UGT1A1*6 and *28 status. There were no significant differences in frequencies of hematological or non-hematological toxicities, regardless of UGT1A1 status.
The CPT-N regimen for recurrent and refractory endometrial carcinoma had tolerable side effects and significant efficacy. This regimen is a viable treatment option for endometrial carcinoma.
我们旨在回顾性评估盐酸伊立替康（CPT）和奈达铂（N）联合治疗复发性和难治性子宫内膜癌的疗效和毒性，该治疗方案基于 UGT1A1 基因型。
在 2009 年至 2017 年间，我们医院对 21 名接受 CPT-N 治疗复发性子宫内膜癌的患者进行了回顾性分析，这些患者作为二线或三线化疗方案。CPT-N 方案包括 CPT-11 40-70mg/m2，第 1、8 和 15 天；奈达铂 50mg/m2，第 1 天，q4 周。
患者的中位年龄为 63 岁。化疗方案数量为 1-2 个。两名患者有盆腔放疗史。CPT-N 治疗的缓解率（完全缓解[CR]与部分缓解[PR]的比值）为 21 例中的 3 例（14.3%），临床获益率（CBR）（CR、PR 和疾病稳定[SD]的总和百分比）为 21 例中的 9 例（42.8%）。毒性包括 3 级中性粒细胞减少症（4 例[19.0%]）、3 级发热性中性粒细胞减少症（2 例[9.5%]）和 3 级腹泻（3 例[14.3%]）；所有患者均经保守治疗缓解。UGT1A1 野生型患者接受了更高剂量的 CPT-11（p=0.048），与 UGT1A16 和28 状态的患者相比，缓解率和 CBR 相似。无论 UGT1A1 状态如何，血液学或非血液学毒性的发生频率均无显著差异。
CPT-N 方案治疗复发性和难治性子宫内膜癌的副作用可耐受，疗效显著。该方案是子宫内膜癌的一种可行的治疗选择。
