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依维莫司治疗东亚患者晚期胃肠道或肺部无功能性神经内分泌肿瘤:RADIANT-4研究的亚组分析

Everolimus for the treatment of advanced gastrointestinal or lung nonfunctional neuroendocrine tumors in East Asian patients: a subgroup analysis of the RADIANT-4 study.

作者信息

Yao James C, Oh Do-Youn, Qian Jiaming, Park Young Suk, Herbst Fabian, Ridolfi Antonia, Izquierdo Miguel, Ito Tetsuhide, Jia Liqun, Komoto Izumi, Sriuranpong Virote, Shimada Yasuhiro

机构信息

Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA,

Department of Medical Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.

出版信息

Onco Targets Ther. 2019 Feb 28;12:1717-1728. doi: 10.2147/OTT.S182259. eCollection 2019.

Abstract

BACKGROUND

In RADIANT-4, everolimus showed an improvement of 7.1 months in median progression-free survival (PFS) vs placebo among patients with advanced, well-differentiated, nonfunctional neuroendocrine tumors (NETs) of gastrointestinal (GI) or lung origin. The present analysis focuses on the effect of everolimus on the East Asian-subgroup population of the RADIANT-4 study.

METHODS

Patients were randomized to receive everolimus 10 mg/day or matching placebo. The primary end point was PFS (central review). Secondary end points were overall response rate, safety, and tolerability.

RESULTS

Among 302 patients enrolled in RADIANT-4, 46 were included in the East Asian subgroup (everolimus, n=28; placebo, n=18) analysis. Everolimus was associated with an 82% reduction in the relative risk of disease progression or death (HR 0.18, 95% CI 0.09-0.38). The median PFS (central review) in this subgroup was 11.2 months with everolimus vs 3.1 months with placebo. Adverse events (AEs) occurred in all 28 patients treated with everolimus and ten patients receiving placebo. The majority of these AEs were grade 1 or 2. Most commonly reported ($30% of incidence) drug-related AEs of any grade included stomatitis (75%, n=21) and rash (43%, n=12) in the everolimus arm.

CONCLUSION

Everolimus demonstrated a clinically meaningful PFS benefit in the East Asian population. The safety findings were consistent with the known safety profile of everolimus. These results support the use of everolimus in the East Asian population with advanced, nonfunctional NETs of GI or lung origin.

摘要

背景

在RADIANT-4研究中,对于晚期、高分化、非功能性胃肠道(GI)或肺源性神经内分泌肿瘤(NETs)患者,依维莫司与安慰剂相比,中位无进展生存期(PFS)延长了7.1个月。本分析聚焦于依维莫司对RADIANT-4研究中东亚亚组人群的影响。

方法

患者被随机分配接受依维莫司10mg/天或匹配的安慰剂。主要终点为PFS(中心审查)。次要终点为总缓解率、安全性和耐受性。

结果

在RADIANT-4研究纳入的302例患者中,46例纳入东亚亚组(依维莫司组,n = 28;安慰剂组,n = 18)分析。依维莫司使疾病进展或死亡的相对风险降低了82%(风险比0.18,95%置信区间0.09 - 0.38)。该亚组中,依维莫司组的中位PFS(中心审查)为11.2个月,而安慰剂组为3.1个月。所有28例接受依维莫司治疗的患者和10例接受安慰剂治疗的患者均发生了不良事件(AE)。这些AE大多为1级或2级。依维莫司组中,任何级别最常报告的(发生率≥30%)与药物相关的AE包括口腔炎(75%,n = 21)和皮疹(43%,n = 12)。

结论

依维莫司在东亚人群中显示出具有临床意义的PFS获益。安全性结果与依维莫司已知的安全性特征一致。这些结果支持在东亚患有晚期、非功能性GI或肺源性NETs的人群中使用依维莫司。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f8/6400121/cd7e0ae6b6fc/ott-12-1717Fig1.jpg

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