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奥希替尼联合雷莫芦单抗治疗 EGFR 突变、T790M 阳性患者:一项 EGFR-TKI 治疗进展后的 Ib 期研究。

Osimertinib With Ramucirumab in EGFR-mutated, T790M-positive Patients With Progression During EGFR-TKI Therapy: Phase Ib Study.

机构信息

Third Department of Internal Medicine, Wakayama Medical University, Wakayama City, Japan.

Third Department of Internal Medicine, Wakayama Medical University, Wakayama City, Japan.

出版信息

Clin Lung Cancer. 2018 Nov;19(6):e871-e874. doi: 10.1016/j.cllc.2018.08.001. Epub 2018 Aug 22.

Abstract

BACKGROUND

Epidermal growth factor receptor (EGFR) T790M mutation is the most frequent mechanism of resistance among patients with progression during EGFR-tyrosine kinase inhibitor (TKI) therapy. A third-generation EGFR-TKI, osimertinib, demonstrated durable efficacy with mild adverse events in a phase III trial and is considered a novel standard regimen. The tolerability of osimertinib monotherapy has allowed for the development of a more efficacious combination regimen. Preclinical and clinical study data have suggested that vascular endothelial growth factor inhibition can enhance EGFR-TKI activity with tolerable toxicity.

AIMS

The aim of the present single-arm, phase Ib study is to assess the tolerability of osimertinib combined with ramucirumab in patients with EGFR-mutated, T790M lung cancer with progression during EGFR-TKI therapy. The primary endpoint is to assess the safety of osimertinib plus ramucirumab at a fixed dose. The secondary endpoints are the overall response rate, progression-free survival, overall survival, and safety. Six patients will be enrolled in the trial.

摘要

背景

表皮生长因子受体(EGFR)T790M 突变是 EGFR-酪氨酸激酶抑制剂(TKI)治疗期间疾病进展患者最常见的耐药机制。第三代 EGFR-TKI 奥希替尼在 III 期临床试验中显示出持久的疗效和轻微的不良反应,被认为是一种新型的标准治疗方案。奥希替尼单药治疗的耐受性允许开发更有效的联合治疗方案。临床前和临床研究数据表明,血管内皮生长因子抑制可以增强 EGFR-TKI 的活性,同时具有可耐受的毒性。

目的

本单臂、Ib 期研究的目的是评估奥希替尼联合雷莫芦单抗在 EGFR 突变、T790M 肺癌患者中的耐受性,这些患者在 EGFR-TKI 治疗期间发生进展。主要终点是评估奥希替尼联合雷莫芦单抗固定剂量的安全性。次要终点是总缓解率、无进展生存期、总生存期和安全性。该试验将招募 6 名患者。

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