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一项在晚期实体瘤患者中进行的维利帕尼联合每两月 FOLFIRI 的 1 期剂量递增研究。

A phase 1 dose-escalation study of veliparib with bimonthly FOLFIRI in patients with advanced solid tumours.

机构信息

Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.

Translational Genomics Research Institute - Virginia G. Piper Cancer Center, Scottsdale, AZ, USA.

出版信息

Br J Cancer. 2018 Apr;118(7):938-946. doi: 10.1038/s41416-018-0003-3. Epub 2018 Mar 12.

DOI:10.1038/s41416-018-0003-3
PMID:29527010
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5933261/
Abstract

BACKGROUND

Veliparib is a potent poly(ADP-ribose) polymerase inhibitor. This phase 1 study aimed to establish the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of veliparib combined with various FOLFIRI regimens in patients with solid tumours.

METHODS

Patients received veliparib (10-270 mg BID, days 1-5, 15-19) and FOLFIRI (days 1-3, 15-17) in three regimens containing 5-fluorouracil 2,400 mg/m: irinotecan 150 mg/m and folinic acid 400 mg/m (part 1); irinotecan 180 mg/m, folinic acid 400 mg/m, and 5-fluorouracil 400 mg/m bolus (part 2), or irinotecan 180 mg/m (part 3). The RP2D was further evaluated in safety expansion cohorts. Preliminary antitumour activity was also assessed.

RESULTS

Ninety-two patients received ≥1 veliparib dose. MTD was not reached; RP2D was set at 200 mg BID veliparib plus FOLFIRI (without 5-fluorouracil bolus). Most common treatment-emergent adverse events were neutropenia (66.3%), diarrhoea, and nausea (60.9% each). Dose-limiting toxicities (n = 4) were grade 3 gastritis and grade 4 neutropenia and febrile neutropenia. Veliparib exposure was dose-proportional, with no effects on the pharmacokinetics of FOLFIRI components. Fifteen patients had a partial response (objective response rate, 17.6%).

CONCLUSIONS

The acceptable safety profile and preliminary antitumour activity of veliparib plus FOLFIRI support further evaluation of this combination.

摘要

背景

维利帕尼是一种有效的聚(ADP-核糖)聚合酶抑制剂。这项 1 期研究旨在确定维利帕尼联合各种 FOLFIRI 方案治疗实体瘤患者的最大耐受剂量(MTD)和推荐的 2 期剂量(RP2D)。

方法

患者接受维利帕尼(10-270mg,bid,第 1-5 天和第 15-19 天)和 FOLFIRI(第 1-3 天和第 15-17 天),方案 3 种,含 5-氟尿嘧啶 2400mg/m:伊立替康 150mg/m 和亚叶酸 400mg/m(部分 1);伊立替康 180mg/m、亚叶酸 400mg/m 和 5-氟尿嘧啶 400mg/m 推注(部分 2)或伊立替康 180mg/m(部分 3)。RP2D 在安全性扩展队列中进一步评估。初步抗肿瘤活性也进行了评估。

结果

92 名患者接受了至少 1 次维利帕尼剂量。未达到 MTD;RP2D 设定为 200mg,bid,维利帕尼联合 FOLFIRI(不含 5-氟尿嘧啶推注)。最常见的治疗相关不良事件是中性粒细胞减少症(66.3%)、腹泻和恶心(各 60.9%)。剂量限制毒性(n=4)为 3 级胃炎和 4 级中性粒细胞减少症和发热性中性粒细胞减少症。维利帕尼暴露与剂量成正比,对 FOLFIRI 成分的药代动力学无影响。15 名患者有部分缓解(客观缓解率为 17.6%)。

结论

维利帕尼联合 FOLFIRI 的可接受安全性特征和初步抗肿瘤活性支持进一步评估该联合方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0487/5933261/fe09534b34cf/41416_2018_3_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0487/5933261/8b56baa2cfd8/41416_2018_3_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0487/5933261/6f8d65907a76/41416_2018_3_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0487/5933261/fe09534b34cf/41416_2018_3_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0487/5933261/8b56baa2cfd8/41416_2018_3_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0487/5933261/6f8d65907a76/41416_2018_3_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0487/5933261/fe09534b34cf/41416_2018_3_Fig3_HTML.jpg

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