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评估达拉非尼联合曲美替尼治疗 BRAF V600 突变阳性晚期皮肤黑色素瘤日本患者的安全性和疗效的 1/2 期研究。

Phase 1/2 study assessing the safety and efficacy of dabrafenib and trametinib combination therapy in Japanese patients with BRAF V600 mutation-positive advanced cutaneous melanoma.

机构信息

Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan.

Dermatology Division, Shizuoka Cancer Center Hospital, Shizuoka, Japan.

出版信息

J Dermatol. 2018 Apr;45(4):397-407. doi: 10.1111/1346-8138.14210. Epub 2018 Feb 5.

Abstract

The combination of dabrafenib and trametinib demonstrated encouraging antitumor activity and tolerability, at initial analysis, in Japanese patients with BRAF V600 mutant advanced melanoma warranting further investigation. This study evaluated the safety and tolerability, pharmacokinetics (PK) and preliminary efficacy of dabrafenib 150 mg b.i.d. plus trametinib 2 mg q.d. in Japanese patients with BRAF V600E/K mutant solid tumors (phase 1) and melanoma (phase 2). Phase 1 was primarily intended to assess safety and tolerability as assessed by adverse events (AE), and the primary end-point in phase 2 was to assess confirmed overall response rate (ORR). The secondary end-points in phase 1 included PK, confirmed/unconfirmed ORR and duration of response (DOR). The secondary end-points in phase 2 were PK, unconfirmed ORR, DOR, safety and tolerability. A total of 12 cutaneous melanoma patients were enrolled in the study (six in phase 1 and six in phase 2) and received the combination therapy of dabrafenib and trametinib. Common AE (≥50.0%) included pyrexia (75%), increased aspartate aminotransferase (67%), peripheral edema (50%) and nasopharyngitis (50%). The investigator-assessed ORR was reported in five patients (83%) in phase 1 and was also reported in five patients (83%; 95% confidence interval, 35.9-99.6; P < 0.0001) in phase 2. Plasma concentrations of both dabrafenib and trametinib seemed to a reach steady state by week 3. Overall, efficacy and PK properties for the dabrafenib plus trametinib combination in Japanese patients were comparable with those seen in global studies.

摘要

达拉非尼联合曲美替尼在初步分析中显示出令人鼓舞的抗肿瘤活性和耐受性,在日本 BRAF V600 突变的晚期黑色素瘤患者中,这一结果需要进一步研究。本研究评估了达拉非尼 150mg,每日两次联合曲美替尼 2mg,每日一次在日本 BRAF V600E/K 突变的实体瘤(I 期)和黑色素瘤(II 期)患者中的安全性、耐受性、药代动力学(PK)和初步疗效。I 期主要目的是通过不良事件(AE)评估安全性和耐受性,II 期的主要终点是评估确认的总缓解率(ORR)。I 期的次要终点包括 PK、确认和未确认的 ORR 及缓解持续时间(DOR)。II 期的次要终点包括 PK、未确认的 ORR、DOR、安全性和耐受性。共有 12 例皮肤黑色素瘤患者入组本研究(I 期 6 例,II 期 6 例),接受达拉非尼联合曲美替尼治疗。常见的 AE(≥50.0%)包括发热(75%)、天门冬氨酸氨基转移酶升高(67%)、外周水肿(50%)和鼻咽炎(50%)。I 期有 5 例患者(83%)评估为研究者评估的 ORR,II 期有 5 例患者(83%;95%置信区间,35.9-99.6;P<0.0001)评估为研究者评估的 ORR。达拉非尼和曲美替尼的血浆浓度在第 3 周似乎达到稳定状态。总的来说,达拉非尼联合曲美替尼在日本患者中的疗效和 PK 特征与全球研究中的结果相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e141/5947742/2a51d3e3358a/JDE-45-397-g001.jpg

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