de Lemos Mário L, Kang Isabell, Schaff Kimberly
Provincial Pharmacy, Systemic Therapy Program, BC Cancer Agency, Vancouver, Canada.
J Oncol Pharm Pract. 2019 Sep;25(6):1301-1304. doi: 10.1177/1078155218784760. Epub 2018 Jun 27.
Patients with locally advanced, recurrent or metastatic solitary fibrous tumour are often treated with bevacizumab and temozolomide based on the clinical efficacy reported in a case series of 14 patients. Given the rarity of solitary fibrous tumour, large trials are not feasible. We report the efficacy of this regimen based on a population-based analysis.
This was a population-based retrospective, multi-centre analysis using patient data from a provincial cancer registry and treatment database. Cases from June 2006 through October 2016 were identified for patients receiving bevacizumab and temozolomide for locally advanced, recurrent or metastatic solitary fibrous tumour or hemangiopericytoma, which is sometimes used to describe tumours arising from the meninges. The primary outcome was overall response rate. Secondary outcomes included time to response, progression free survival and overall survival estimated using the Kaplan-Meier method.
Fourteen patients were identified: median age 59 (range 44-70), male 78.6%. Diagnoses were solitary fibrous tumour in 10 (71.4%) and hemangiopericytoma in four (28.6%), with metastatic disease in 10 (72.7%) patients. The most common primary sites were meninges in four (28.6%) and pelvis in three (21.4%) patients. The median follow-up was 15.5 months, with median treatment of four months. Overall response rate was 21.4% (no complete response, 3 partial response), with median time to response of four months. Median progression free survival, six-month progression free survival and overall survival were 17 months, 65.0%, and 45 months, respectively.
Efficacy of bevacizumab and temozolomide in solitary fibrous tumour appeared to be similar to that previously reported. Our findings confirmed that bevacizumab and temozolomide is an effective and tolerated treatment for this patient population.
局部晚期、复发或转移性孤立性纤维瘤患者常根据一项纳入14例患者的病例系列报告的临床疗效，接受贝伐单抗和替莫唑胺治疗。鉴于孤立性纤维瘤罕见，开展大型试验并不可行。我们基于人群分析报告了该治疗方案的疗效。
这是一项基于人群的回顾性多中心分析，使用了省级癌症登记处和治疗数据库中的患者数据。确定了2006年6月至2016年10月期间接受贝伐单抗和替莫唑胺治疗的局部晚期、复发或转移性孤立性纤维瘤或血管外皮细胞瘤（有时用于描述起源于脑膜的肿瘤）患者。主要结局为总缓解率。次要结局包括缓解时间、无进展生存期和使用Kaplan-Meier方法估计的总生存期。
共确定了14例患者：中位年龄59岁（范围44 - 70岁），男性占78.6%。诊断为孤立性纤维瘤10例（71.4%），血管外皮细胞瘤4例（28.6%），10例（72.7%）患者有转移性疾病。最常见的原发部位是4例（28.6%）患者的脑膜和3例（21.4%）患者的骨盆。中位随访时间为15.5个月，中位治疗时间为4个月。总缓解率为21.4%（无完全缓解，3例部分缓解），中位缓解时间为4个月。中位无进展生存期、6个月无进展生存率和总生存期分别为17个月、65.0%和45个月。
贝伐单抗和替莫唑胺治疗孤立性纤维瘤的疗效似乎与先前报告的相似。我们的研究结果证实，贝伐单抗和替莫唑胺对该患者群体是一种有效且耐受性良好的治疗方法。
