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贝伐珠单抗联合吉西他滨治疗铂耐药复发性卵巢癌:一项回顾性分析。

Addition of bevacizumab to gemcitabine for platinum-resistant recurrent ovarian cancer: a retrospective analysis.

机构信息

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.

出版信息

Cancer Chemother Pharmacol. 2018 May;81(5):809-814. doi: 10.1007/s00280-018-3552-5. Epub 2018 Mar 2.

Abstract

PURPOSE

To compare a cohort of patients with platinum-resistant recurrent ovarian cancer (PROC) treated with bevacizumab and gemcitabine (Bev-Gem) to that of patients treated only with gemcitabine (Gem).

METHODS

Between 2011 and 2017, we identified the Bev-Gem and Gem PROC groups. The regimen included 1000 mg/m of Gem on days 1, 8, and 15, and 15 mg/m of Bev on day 1, every 4 weeks. Progression-free survival (PFS) and overall survival (OS) were calculated from the date of the administration of Bev-Gem or Gem until disease progression or death.

RESULTS

The Bev-Gem and Gem groups included 18 and 29 patients, respectively. More patients had advanced stage disease in the Bev-Gem group (p = 0.048); no other characteristics differed between the groups. The response rates [ratio of complete remission (CR) to partial remission (PR)] of Bev-Gem and Gem were 38.9 and 3.4%, respectively (p < 0.01). The clinical benefit rates [combined percentages of CR, PR, and stable disease] of the Bev-Gem and Gem groups were 88.9 and 41.4%, respectively (p = 0.04). PFS and OS of the Bev-Gem group were superior (p < 0.01, p = 0.03, respectively). Bev-Gem was the better prognostic factor of both PFS [hazard ratio (HR) 0.17, p < 0.01] and OS (HR 0.31, p = 0.01). The frequency of hematologic and non-hematologic adverse effects was similar in each group.

CONCLUSION

Bev-Gem regimens improved PFS and OS for PROC. Furthermore, the adverse effects of Bev-Gem were tolerable. Thus, Bev-Gem could be a candidate treatment strategy for PROC.

摘要

目的

比较贝伐珠单抗联合吉西他滨(Bev-Gem)与单纯吉西他滨(Gem)治疗铂耐药复发性卵巢癌(PROC)的患者队列。

方法

2011 年至 2017 年,我们确定了 Bev-Gem 和 Gem PROC 组。方案包括 1000mg/m 的 Gem,第 1、8 和 15 天使用,15mg/m 的 Bev,第 1 天使用,每 4 周一次。从 Bev-Gem 或 Gem 给药日期到疾病进展或死亡计算无进展生存期(PFS)和总生存期(OS)。

结果

Bev-Gem 和 Gem 组分别包括 18 例和 29 例患者。Bev-Gem 组中晚期疾病患者更多(p=0.048);两组之间无其他特征差异。Bev-Gem 和 Gem 的反应率(完全缓解(CR)与部分缓解(PR)的比值)分别为 38.9%和 3.4%(p<0.01)。Bev-Gem 和 Gem 组的临床获益率(CR、PR 和稳定疾病的综合百分比)分别为 88.9%和 41.4%(p=0.04)。Bev-Gem 组的 PFS 和 OS 均较好(p<0.01,p=0.03)。Bev-Gem 是 PFS(风险比(HR)0.17,p<0.01)和 OS(HR 0.31,p=0.01)的更好预后因素。两组的血液学和非血液学不良反应频率相似。

结论

Bev-Gem 方案改善了 PROC 的 PFS 和 OS。此外,Bev-Gem 的不良反应可耐受。因此,Bev-Gem 可能是 PROC 的候选治疗策略。

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