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AMG 337 治疗 - 扩增型胃/胃食管结合部/食管腺癌和其他 - 扩增型实体瘤患者的多中心 II 期研究。

A Multicenter Phase II Study of AMG 337 in Patients with -Amplified Gastric/Gastroesophageal Junction/Esophageal Adenocarcinoma and Other -Amplified Solid Tumors.

机构信息

Department of Digestive Oncology, University Hospitals Gasthuisberg, Leuven, and KU Leuven, Leuven, Belgium.

Department of Oncology, Przychodnia Lekarska NZOZ KOMED, Konin, Poland.

出版信息

Clin Cancer Res. 2019 Apr 15;25(8):2414-2423. doi: 10.1158/1078-0432.CCR-18-1337. Epub 2018 Oct 26.

Abstract

PURPOSE

gene amplification is associated with poor prognosis in gastric/gastroesophageal junction/esophageal (G/GEJ/E) cancers. We determined antitumor activity, safety, and pharmacokinetics of the small-molecule MET inhibitor AMG 337 in -amplified G/GEJ/E adenocarcinoma or other solid tumors. In this phase II, single-arm study, adults with -amplified G/GEJ/E adenocarcinoma (cohort 1) or other -amplified solid tumors (cohort 2) received AMG 337 300 mg/day orally in 28-day cycles. The primary endpoint was objective response rate (ORR; cohort 1). Secondary endpoints included ORR (cohort 2), progression-free survival (PFS), overall survival (OS), and safety.

RESULTS

Of 2101 patients screened for amplification, 132 were -amplified and 60 were enrolled: 45 in cohort 1, and 15 in cohort 2. Fifty-six patients (97%) had metastatic disease; 57 had prior lines of therapy (1 prior line, 29%; ≥2 prior lines, 69%). A protocol-permitted review showed efficacy that was lower-than-expected based on preliminary data from a first-in-human study, and enrollment was stopped. Fifty-eight patients received ≥1 AMG 337 dose. ORR in cohort 1 was 18% (8 partial responses). No responses were observed in cohort 2. Of 54 evaluable patients, median (95% CI) PFS and OS were 3.4 (2.2-5.0) and 7.9 (4.8-10.9) months, respectively. The most frequent adverse events (AEs) were headache (60%), nausea (38%), vomiting (38%), and abdominal pain, decreased appetite, and peripheral edema (33% each); 71% had grade ≥3 AEs and 59% had serious AEs.

CONCLUSIONS

AMG 337 showed antitumor activity in -amplified G/GEJ/E adenocarcinoma but not in -amplified non-small-cell lung cancer..

摘要

目的

基因扩增与胃/胃食管交界处/食管(G/GEJ/E)癌症的预后不良相关。我们确定了小分子 MET 抑制剂 AMG 337 在 -扩增 G/GEJ/E 腺癌或其他实体瘤中的抗肿瘤活性、安全性和药代动力学。在这项 II 期、单臂研究中,-扩增 G/GEJ/E 腺癌(队列 1)或其他 -扩增实体瘤(队列 2)的成年患者每日口服 AMG 337 300mg,每 28 天为一个周期。主要终点是客观缓解率(ORR;队列 1)。次要终点包括 ORR(队列 2)、无进展生存期(PFS)、总生存期(OS)和安全性。

结果

在筛选的 132 例患者中,有 132 例患者存在扩增,其中 60 例患者入组:队列 1 45 例,队列 2 15 例。56 例患者(97%)患有转移性疾病;57 例患者有既往治疗线数(1 线治疗,29%;≥2 线治疗,69%)。一项协议允许的审查显示,疗效低于首次人体研究初步数据所预期的疗效,因此停止了入组。58 例患者接受了≥1 剂 AMG 337。队列 1 的 ORR 为 18%(8 例部分缓解)。队列 2 未观察到缓解。54 例可评估患者的中位(95%CI)PFS 和 OS 分别为 3.4(2.2-5.0)和 7.9(4.8-10.9)个月。最常见的不良事件(AE)为头痛(60%)、恶心(38%)、呕吐(38%)和腹痛、食欲下降和外周水肿(各 33%);71%的患者发生≥3 级 AE,59%的患者发生严重 AE。

结论

AMG 337 在 -扩增 G/GEJ/E 腺癌中显示出抗肿瘤活性,但在 -扩增非小细胞肺癌中没有。

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