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法米替尼对比安慰剂治疗难治性转移性结直肠癌:一项多中心、随机、双盲、安慰剂对照的II期临床试验。

Famitinib versus placebo in the treatment of refractory metastatic colorectal cancer: a multicenter, randomized, double-blinded, placebo-controlled, phase II clinical trial.

作者信息

Xu Rui-Hua, Shen Lin, Wang Ke-Ming, Wu Gang, Shi Chun-Mei, Ding Ke-Feng, Lin Li-Zhu, Wang Jin-Wan, Xiong Jian-Ping, Wu Chang-Ping, Li Jin, Liu Yun-Peng, Wang Dong, Ba Yi, Feng Jue-Ping, Bai Yu-Xian, Bi Jing-Wang, Ma Li-Wen, Lei Jian, Yang Qing, Yu Hao

机构信息

Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong, P. R. China.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, No 52, Fucheng Road, Haidian District, Beijing, 100142, P. R. China.

出版信息

Chin J Cancer. 2017 Dec 22;36(1):97. doi: 10.1186/s40880-017-0263-y.

Abstract

BACKGROUND

Metastatic colorectal cancer (mCRC) patients with progressive disease after all available standard therapies need new medication for further treatment. Famitinib is a small-molecule multikinase inhibitor, with promising anticancer activities. This multicenter, randomized, double-blinded, placebo-controlled, phase II clinical trial was designed to evaluate the safety and efficacy of famitinib in mCRC.

METHODS

Famitinib or placebo was administered orally once daily. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), quality-of-life (QoL), and safety.

RESULTS

Between July 18, 2012 and Jan 22, 2014, a total of 167 patients were screened, and 154 patients were randomized in a 2:1 ratio to receive either famitinib (n = 99) or placebo (n = 55). The median PFS was 2.8 and 1.5 months in the famitinib and placebo groups (hazard ratio = 0.60, 95% confidence interval = 0.41-0.86, P = 0.004). The DCR was 59.8% and 31.4% (P = 0.002) and the ORR was 2.2% and 0.0% (P = 0.540) in the famitinib and placebo groups, respectively. The most frequent grade 3-4 adverse events were hypertension (11.1%), hand-foot syndrome (10.1%), thrombocytopenia (10.1%), and neutropenia (9.1%). Serious adverse events occurred in 11 (11.1%) patients in the famitinib group and 5 (9.1%) in the placebo group (P = 0.788). The median OS of the famitinib and placebo groups was 7.4 and 7.2 months (P = 0.657).

CONCLUSION

Famitinib prolonged PFS in refractory mCRC patients with acceptable tolerability. Trial registration This study was registered on ClinicalTrials.gov (NCT01762293) and was orally presented in the 2015 ASCO-Gastrointestinal Symposium.

摘要

背景

所有可用标准治疗后疾病进展的转移性结直肠癌(mCRC)患者需要新的药物进行进一步治疗。法米替尼是一种小分子多激酶抑制剂,具有有前景的抗癌活性。这项多中心、随机、双盲、安慰剂对照的II期临床试验旨在评估法米替尼在mCRC中的安全性和疗效。

方法

法米替尼或安慰剂每日口服一次。主要终点为无进展生存期(PFS)。次要终点包括客观缓解率(ORR)、疾病控制率(DCR)、总生存期(OS)、生活质量(QoL)和安全性。

结果

在2012年7月18日至2014年1月22日期间,共筛选了167例患者,154例患者按2:1的比例随机分组,分别接受法米替尼(n = 99)或安慰剂(n = 55)治疗。法米替尼组和安慰剂组的中位PFS分别为2.8个月和1.5个月(风险比 = 0.60,95%置信区间 = 0.41 - 0.86,P = 0.004)。法米替尼组和安慰剂组的DCR分别为59.8%和31.4%(P = 0.002),ORR分别为2.2%和0.0%(P = 0.540)。最常见的3 - 4级不良事件为高血压(11.1%)、手足综合征(10.1%)、血小板减少(10.1%)和中性粒细胞减少(9.1%)。法米替尼组11例(11.1%)患者和安慰剂组5例(9.1%)患者发生严重不良事件(P = 0.788)。法米替尼组和安慰剂组的中位OS分别为7.4个月和7.2个月(P = 0.657)。

结论

法米替尼可延长难治性mCRC患者的PFS,且耐受性可接受。试验注册本研究在ClinicalTrials.gov(NCT01762293)上注册,并在2015年美国临床肿瘤学会-胃肠病学研讨会上进行了口头报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a971/5741870/a7aac9837af1/40880_2017_263_Fig1_HTML.jpg

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