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曲贝替定联合聚乙二醇化脂质体阿霉素治疗卵巢肿瘤患者。

Trabectedin in combination with pegylated liposomal doxorubicin in patients with ovarian tumors.

作者信息

Villanucci Alessandro, Tavella Ketty, Vannini Laura, Rossi Virginia, Nobili Stefania, Amunni Gianni, Mazzei Teresita, Mini Enrico

机构信息

Department of Oncology, Hospital-University Agency of Careggi, I-50134 Florence, Italy.

Department of Oncology, University of Florence, I-50134 Florence, Italy.

出版信息

Mol Clin Oncol. 2018 Dec;9(6):635-639. doi: 10.3892/mco.2018.1729. Epub 2018 Oct 1.

Abstract

The majority of patients with ovarian cancer will experience relapse and thus require second-line therapy. While platinum-based therapies are the primary treatments for refractory disease other options are required, particularly for those with partially platinum-sensitive disease as their response rates are lower. Agents that can resensitize relapsed ovarian cancers to platinum, including trabectedin, are therefore of increasing interest. Trabectedin is a multitarget agent that has a complex, novel mechanism of action and has exhibited promising results in platinum-sensitive ovarian cancer when in combination with pegylated liposomal doxorubicin (PLD). The present study conducted retrospective analysis involving 11 cases (median age 60 years; range 45-75 years) of recurrent ovarian tumors and partial platinum sensitivity undergoing treatment with trabectedin + PLD. The cohort consisted of 7 serous carcinomas, 1 endometrial carcinoma, 2 undifferentiated carcinomas, and 1 mucinous carcinoma. Of the 11 patients, 4 exhibited a complete response, 3 achieved stable disease, and 4 had progression of disease. Mean overall survival was 32.42 months and median progression-free survival was 5.9 months. Trabectedin in combination with PLD was well tolerated in terms of gastrointestinal and hematological toxicity; Grade 3 cutaneous toxicity and grade 3 neutropenia were each observed in 18.2% of patients. There were no grade 4 events. Thus, the present study supports the use of trabectedin + PLD in patients with relapsed ovarian cancer and partial platinum sensitivity, with predictable and manageable toxicity.

摘要

大多数卵巢癌患者会出现复发,因此需要二线治疗。虽然铂类疗法是难治性疾病的主要治疗方法,但还需要其他选择,特别是对于那些对铂类药物部分敏感的患者,因为他们的缓解率较低。因此,能够使复发性卵巢癌对铂类药物重新敏感的药物,包括曲贝替定,越来越受到关注。曲贝替定是一种多靶点药物,具有复杂、新颖的作用机制,并且在与聚乙二醇化脂质体阿霉素(PLD)联合使用时,在铂类敏感的卵巢癌中显示出有前景的结果。本研究对11例(中位年龄60岁;范围45 - 75岁)接受曲贝替定 + PLD治疗的复发性卵巢肿瘤且对铂类药物部分敏感的患者进行了回顾性分析。该队列包括7例浆液性癌、1例子宫内膜癌、2例未分化癌和1例黏液性癌。11例患者中,4例完全缓解,3例病情稳定,4例病情进展。平均总生存期为32.42个月,中位无进展生存期为5.9个月。曲贝替定与PLD联合使用在胃肠道和血液学毒性方面耐受性良好;18.2%的患者分别出现3级皮肤毒性和3级中性粒细胞减少。没有4级事件发生。因此,本研究支持在复发性卵巢癌且对铂类药物部分敏感的患者中使用曲贝替定 + PLD,其毒性可预测且易于管理。

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本文引用的文献

1
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2
Stable disease in a patient with metastatic leiomyosarcoma treated with trabectedin.
Anticancer Drugs. 2017 Apr;28(4):465-468. doi: 10.1097/CAD.0000000000000485.
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EJC Suppl. 2014 Dec;12(2):7-12. doi: 10.1016/S1359-6349(15)70004-2. Epub 2015 Jan 13.
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Optimizing treatment of the partially platinum-sensitive ovarian cancer patient.
Future Oncol. 2013 Dec;9(12 Suppl):19-23. doi: 10.2217/fon.13.206.

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